Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 10203 | NC |
NPI | 1043448780 |
---|---|
Provider Name | Dr. John H Foley |
First Address | Raleigh, NC 27616-6685 |
Second Address | Raleigh, NC 27616-6685 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2009 |
Last Update Date | 09/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ENROLLED | (05) | MN |