Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 2013-00940 | NC |
N | 207YP0228X | Pediatric Otolaryngology | 036143914 | IL |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 2013-00940 | NC |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | A 119313 | CA |
NPI | 1700080678 |
---|---|
Provider Name | Dr. Joshua Benjamin Surowitz |
First Address | Charlotte, NC 28203-5103 |
Second Address | Charlotte, NC 28203-5103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 20/06/2019 |