Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 26065 | NC |
NPI | 1447231519 |
---|---|
Provider Name | Dr. Fred Donald Vermeulen |
First Address | Charlotte, NC 28204-2408 |
Second Address | Charlotte, NC 28204-2408 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2005 |
Last Update Date | 02/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8984992 | (05) | NC |
C86910 | (02) |