Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2004-0296 | NM |
N | 111NI0900X | Internist | 2004-0296 | NM |
Y | 207RC0000X | Internist - Cardiovascular Disease | 2008-01121 | NC |
NPI | 1023157047 |
---|---|
Provider Name | Dr. Cody Scott Deen |
First Address | Morrisville, NC 27560-8421 |
Second Address | Siler City, NC 27344-6790 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 11/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5917915 | (05) | NC |