Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 31539 | NC |
Y | 111NI0900X | Internist | 31539 | NC |
N | 207RG0300X | Geriatric Medicine | 31539 | NC |
NPI | 1073508149 |
---|---|
Provider Name | Dr. Rodger D Israel |
First Address | Raleigh, NC 27612-8036 |
Second Address | Raleigh, NC 27612-8036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2005 |
Last Update Date | 19/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8945461 | (05) | NC |
C87507 | (02) | NC |