Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 19411 | NC |
NPI | 1437222627 |
---|---|
Provider Name | Dr. Robert T Teeter |
First Address | Boone, NC 28607-5915 |
Second Address | Boone, NC 28607-5915 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0709B | BLUE CROSS BLUE SHIELD (01) | NC |
0709K | BLUE CROSS BLUE SHIELD (01) | NC |
0709W | BLUE CROSS BLUE SHIELD (01) | NC |
3404303 | (05) | NC |
3404305 | (05) | NC |
3404395 | (05) | NC |
C89611 | (02) | NC |