Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 9700938 | NC |
NPI | 1134111289 |
---|---|
Provider Name | Dr. Eric Tomson Emerson |
First Address | Gastonia, NC 28054-7424 |
Second Address | Gastonia, NC 28054-7424 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 23/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1064R | BCBS (01) | |
2239417C | MEDICARE (01) | |
2239417D | MEDICARE (01) | |
891064R | (05) | NC |
G30023 | (02) |