Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 200400782 | NC |
NPI | 1073510046 |
---|---|
Provider Name | Dr. Nathan Ashley Woolwine |
First Address | Charlotte, NC 28204-3053 |
Second Address | Concord, NC 28025-2405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2005 |
Last Update Date | 04/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1398R | BCBS PROVIDER (01) | NC |
4504731 | CIGNA HEALTHCARE (01) | NC |
5902823 | (05) | NC |
7222609 | AETNA PROVIDER (01) | NC |
805293 | PARTNERS MEDICARE (01) | NC |
E3298 | MEDCOST PROVIDER (01) | NC |
I14799 | (02) | NC |
P00194087 | RR MCARE (01) | NC |