Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 200000317 | NC |
NPI | 1629048004 |
---|---|
Provider Name | Dr. Jared Spector |
First Address | Cary, NC 27518-6566 |
Second Address | Cary, NC 27518-6566 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2006 |
Last Update Date | 28/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
791265E | (05) | NC |
H22765 | (02) | NC |