Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 2005-01022 | NC |
NPI | 1356317390 |
---|---|
Provider Name | Dr. Louis C Fiore |
First Address | Charlotte, NC 28209-3239 |
Second Address | Shelby, NC 28150-3575 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2006 |
Last Update Date | 12/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5903143 | (05) | NC |
I35630 | (02) | NC |