Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 9700973 | NC |
N | 208600000X | Surgeon | 9700973 | NC |
Y | 2086X0206X | Surgical Oncologist | 9700973 | NC |
NPI | 1184648123 |
---|---|
Provider Name | Dr. Fredrick L Greene |
First Address | Charlotte, NC 28203-5812 |
Second Address | Charlotte, NC 28203-5812 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 06/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100116 | (05) | SC |
1076Q | NCBCBS (01) | NC |
891076Q | (05) | NC |
C60301 | (02) | NC |