Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 204 | NC |
N | 213ES0103X | Foot & Ankle Surgery | 204 | NC |
N | 213ES0131X | Foot Surgery | 204 | NC |
NPI | 1528011376 |
---|---|
Provider Name | Dr. Ronald V Futerman |
First Address | Matthews, NC 28106-1539 |
Second Address | Matthews, NC 28105-1729 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 04/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0822M | BCBS NC (01) | NC |
890822M | (05) | NC |
T64061 | (02) | NC |