Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 1256 | NC |
NPI | 1639105547 |
---|---|
Provider Name | Dr. Ronald Steven Demars |
First Address | Greensboro, NC 27455-1605 |
Second Address | Greensboro, NC 27455-1605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
08343 | BLUE CROSS BLUE SHIELD (01) | NC |
8908343 | (05) | NC |
T64403 | (02) | NC |