Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 29322 | NC |
N | 207QS0010X | Family Doctor - Sports Medicine | 29322 | NC |
NPI | 1124020912 |
---|---|
Provider Name | Dr. Lawrence Max Linett |
First Address | Wilmington, NC 28401-4328 |
Second Address | Wilmington, NC 28405-6427 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2005 |
Last Update Date | 27/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8910174 | (05) | NC |
C82218 | (02) | NC |