Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 2007-00185 | NC |
NPI | 1306801170 |
---|---|
Provider Name | Dr. Fred W. Ortmann IV |
First Address | Greensboro, NC 27438-8008 |
Second Address | Greensboro, NC 27408-7602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2006 |
Last Update Date | 15/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2067221 | (02) | NC |
5906724 | (05) | NC |