Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0129X | Vascular Surgeon | 200301302 | NC |
NPI | 1033179122 |
---|---|
Provider Name | Dr. Luan Tran |
First Address | Raleigh, NC 27607-3078 |
Second Address | Raleigh, NC 27607-3077 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 26/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1548206022 | MEDICARE RAILROAD INDIVIDUAL PTAN (01) | NC |
2323842 | GROUP MEDICARE PTAN (01) | NC |
DE0112 | GROUP MEDICARE RAILROAD PTAN (01) | NC |
G45985 | (02) |