Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 0103000728 | VA |
Y | 222Z00000X | Podiatrist | 0103000728 | VA |
NPI | 1043328404 |
---|---|
Provider Name | Dr. Cory Allan Negri |
First Address | Portsmouth, VA 23703-3314 |
Second Address | Portsmouth, VA 23703-3314 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009302565 | (05) | VA |
028304BCBS | ANTHEM BCBS (01) | VA |
480006062RRMCR | PALMETTO GBA (01) | GA |
T21374 | (02) |