Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 524 | NC |
N | 213ES0103X | Foot & Ankle Surgery | 697 | TN |
NPI | 1073750683 |
---|---|
Provider Name | Dr. Joe K Ades |
First Address | Mooresville, NC 28117 |
Second Address | Mooresville, NC 28117 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2009 |
Last Update Date | 29/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3714470 | GROUP NPI (01) | TN |