Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 01039290A | IN |
NPI | 1154388619 |
---|---|
Provider Name | Dr. Ishik C Tuna |
First Address | Clemmons, NC 27012-8410 |
Second Address | Clemmons, NC 27012-8410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E88966 | (02) | IN |