Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 01030012 | IN |
N | 208600000X | Surgeon | 01030012 | IN |
N | 2086S0120X | Pediatric Surgery | 042-0008206 | VT |
N | 2086S0120X | Pediatric Surgery | 2008013256 | MO |
Y | 2086S0120X | Pediatric Surgery | 40374 | SC |
NPI | 1407887722 |
---|---|
Provider Name | Dr. Dennis W Vane |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425-1003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 26/11/2019 |