Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 0099-01404 | NC |
NPI | 1083623268 |
---|---|
Provider Name | Dr. Michael Owen Ferguson |
First Address | Raleigh, NC 27604-0010 |
Second Address | Raleigh, NC 27610-1247 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 23/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8913022 | (05) | NC |
H57596 | (02) |