Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 13502 | NC |
NPI | 1073937942 |
---|---|
Provider Name | Dr. John Monroe |
First Address | West End, NC 27376-8961 |
Second Address | West End, NC 27376-8961 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2014 |
Last Update Date | 12/02/2014 |