Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 39325 | GA |
Y | 208600000X | Surgeon | 39325 | GA |
N | 2082S0105X | Plastic Hand Surgeon | 39325 | GA |
NPI | 1346301231 |
---|---|
Provider Name | Dr. Robert Charles Dinsmore |
First Address | Augusta, GA 30901-2602 |
Second Address | Augusta, GA 30912-0004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 17/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
194992999A | (05) | GA |
52227756 001 | BCBS (01) | GA |
G39325 | (05) | SC |