Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 9600348 | NC |
NPI | 1053320515 |
---|---|
Provider Name | Dr. Howard G Oaks |
First Address | Fayetteville, NC 28304-4418 |
Second Address | Fayetteville, NC 28304-4418 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 30/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5904150 | (05) | NC |
7274815 | AETNA (01) | NC |
7586793 | CIGNA (01) | NC |
I64210 | (02) | NC |
P00642094 | RR MEDICARE (01) | NC |