Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 2007-01919 | NC |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 2007-01919 | NC |
NPI | 1730177411 |
---|---|
Provider Name | Dr. Richard Todd Weisenburger |
First Address | Murphy, NC 28906-6663 |
Second Address | Murphy, NC 28906-6663 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2005 |
Last Update Date | 30/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D60783 | (02) | NC |