Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 9700621 | NC |
NPI | 1427017284 |
---|---|
Provider Name | Dr. Frank Joseph Kosarek |
First Address | Charlotte, NC 28222-1249 |
Second Address | Charlotte, NC 28211 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2006 |
Last Update Date | 12/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
891052K | (05) | NC |
G52534 | (02) | |
Q00621 | (05) | SC |