Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 200300208 | NC |
N | 208000000X | Pediatrician | 200300208 | NC |
NPI | 1336129410 |
---|---|
Provider Name | Dr. Robert Christopher Van Winkle |
First Address | Greensboro, NC 27410-9682 |
Second Address | Greensboro, NC 27410-9682 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2006 |
Last Update Date | 12/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H84574 | (02) | NC |