Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 002717 | NY |
N | 111NI0900X | Internist | 002717 | NY |
N | 207R00000X | Internist | 2007-00528 | NC |
N | 111NI0900X | Internist | 2007-00528 | NC |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 2007-00528 | NC |
N | 207RC0000X | Internist - Cardiovascular Disease | 2007-00528 | NC |
NPI | 1992885545 |
---|---|
Provider Name | Dr. Geoffrey Te Jao |
First Address | Winston Salem, NC 27157-0001 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 18/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
145HT | BCBS (01) | NC |
199206 | MEDCOST (01) | NC |
1992885545 | (05) | VA |
3810009020 | (05) | WV |
5906676 | (05) | NC |
810599 | PARTNERS (01) | NC |
9164064 | AETNA (01) | NC |
I70788 | (02) | |
Q0052M | (05) | SC |