Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 14833 | NC |
NPI | 1083828982 |
---|---|
Provider Name | Dr. James Keller Weingarten |
First Address | Southport, NC 28461-3038 |
Second Address | Southport, NC 28461-3038 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 08/07/2007 |