Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 2016-01245 | NC |
Y | 208600000X | Surgeon | 2016-01245 | NC |
N | 2086S0127X | Trauma Surgeon | 2016-01245 | NC |
NPI | 1366766941 |
---|---|
Provider Name | Dr. Nicole Marie Garcia |
First Address | Charlotte, NC 28275-1069 |
Second Address | Greenville, NC 27834-2849 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2010 |
Last Update Date | 16/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1366766941 | (05) | NC |
19KJ8 | BCBS OF NC (01) | NC |