Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 1371 | NC |
N | 111NN1001X | Nutrition | X-003440-1 | NY |
NPI | 1609988286 |
---|---|
Provider Name | Dr. John Ernest Weisberg |
First Address | Wilmington, NC 28401 |
Second Address | Wilmington, NC 28401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T86344 | (02) | NY |