Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 19438 | NC |
NPI | 1033108295 |
---|---|
Provider Name | Dr. Robert Howell Beaver |
First Address | Charlotte, NC 28209-3239 |
Second Address | Concord, NC 28025-2402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2005 |
Last Update Date | 02/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8914185 | (05) | NC |
C82759 | (02) | |
Q38074 | (05) | SC |