Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 9500544 | NC |
N | 111NI0900X | Internist | 9500544 | NC |
Y | 207R00000X | Internist | MD15166 | RI |
Y | 111NI0900X | Internist | MD15166 | RI |
N | 207RN0300X | Nephrologist | 19319 | SC |
N | 207RN0300X | Nephrologist | 95-00544 | NC |
N | 207RN0300X | Nephrologist | ME65416 | FL |
NPI | 1053377630 |
---|---|
Provider Name | Dr. Henry D Cremisi |
First Address | Charlotte, NC 28260-0447 |
Second Address | Matthews, NC 28105-4656 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2006 |
Last Update Date | 30/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
20302 | PARTNERS (01) | NC |
25593 | BCBSNC (01) | NC |
276908 | MAMSI (01) | NC |
290003571 | MEDICARE RAILROAD (01) | NC |
561550231G | CIGNA (01) | NC |
8925593 | (05) | NC |
E93176 | (02) | NC |
N00544 | (05) | SC |