Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP1101X | Primary Podiatric Medicine | 449 | NC |
Y | 213ES0103X | Foot & Ankle Surgery | 449 | NC |
N | 213ES0131X | Foot Surgery | 449 | NC |
NPI | 1497722672 |
---|---|
Provider Name | Dr. Kevin Gregory Bachman |
First Address | Wilmington, NC 28401-7406 |
Second Address | Wilmington, NC 28401-7406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2006 |
Last Update Date | 18/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0807N | BCBS NC (01) | NC |
890807N | (05) | NC |
E1550 | MEDCOST (01) | NC |
E1552 | MEDCOST (01) | NC |
P00959570 | MEDICARE RAILROAD (01) | |
U86950 | (02) | NC |