Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 2012-00250 | NC |
NPI | 1013177021 |
---|---|
Provider Name | Dr. Stephen Thomas Rancour |
First Address | Charlotte, NC 28260-2598 |
Second Address | Greensboro, NC 27401-1004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2008 |
Last Update Date | 01/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5920241 | (05) | NC |