Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 2006-01896 | NC |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 2006-01896 | NC |
NPI | 1164576369 |
---|---|
Provider Name | Dr. George A Azar |
First Address | Charlotte, NC 28260-0447 |
Second Address | Thomasville, NC 27360-3428 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 28/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5906942 | (05) | NC |
P00429517 | RAILROAD MEDICARE (01) | NC |