Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 196 | NC |
Y | 222Z00000X | Podiatrist | 196 | NC |
NPI | 1053368704 |
---|---|
Provider Name | Dr. Matthew Gray Troxler |
First Address | Burlington, NC 27216-1717 |
Second Address | Burlington, NC 27215-8700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2006 |
Last Update Date | 30/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8908149 | (05) | NC |
T64060 | (02) | NC |