Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 45211 | MN |
Y | 2080P0216X | Pediatric Rheumatologist | 2010-01376 | NC |
NPI | 1871521443 |
---|---|
Provider Name | Dr. Jeffrey Arthur Dvergsten |
First Address | Durham, NC 27705-3941 |
Second Address | Durham, NC 27705-3941 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2006 |
Last Update Date | 19/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0147475 | (05) | MT |
0597021 | (05) | MN |
1033631 | PREFERRED ONE (01) | MN |
12-03423 | MEDICA CHOICE (01) | MN |
12-09026 | MEDICA CHOICE (01) | MN |
171323 | UCARE (01) | MN |
1864181 | ARAZ (01) | MN |
34800400 | (05) | WI |
552443100 | (05) | MN |
631T9DV | BCBS (01) | MN |
HP37914 | HEALTHPARTNERS (01) | MN |