Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 0039442 | NC |
NPI | 1134144173 |
---|---|
Provider Name | Dr. John Carl Liguori |
First Address | Wilmington, NC 28412-2486 |
Second Address | Wilmington, NC 28412-2486 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8951935 | (05) | NC |
B62573 | (02) | NC |