Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 042376 | GA |
N | 207K00000X | Allergist & Immunologist | 20140 | SC |
Y | 207K00000X | Allergist & Immunologist | 95-00677 | NC |
N | 207K00000X | Allergist & Immunologist | 9500677 | NC |
NPI | 1114952322 |
---|---|
Provider Name | Dr. John Gray Norris |
First Address | Charlotte, NC 28263-3376 |
Second Address | Charlotte, NC 28204-4375 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 26/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
89111Q | (05) | NC |
BCBS | 01284 (01) | NC |
G65848 | (02) | |
N00677 | (05) | SC |
PC6542GROUP | (05) | SC |