Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301093964 | MI |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 2013-00440 | NC |
N | 2080P0207X | Pediatric Hematology-Oncologist | 4301093964 | MI |
NPI | 1265611289 |
---|---|
Provider Name | Dr. George Edward Hucks JR. |
First Address | Charlotte, NC 28275-1069 |
Second Address | Greenville, NC 27834-4300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2007 |
Last Update Date | 07/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1265611289 | (05) | NC |
179UU | BCBSNC (01) | NC |
60093B | (02) | NC |