Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 2246 | NC |
NPI | 1720168602 |
---|---|
Provider Name | Dr. Gustave Ferreri |
First Address | Charlotte, NC 28210-8492 |
Second Address | Charlotte, NC 28210-8492 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U41700 | (02) | NC |