Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 1318 | NC |
Y | 103T00000X | Psychologist | 1318 | NC |
NPI | 1003807611 |
---|---|
Provider Name | Dr. Steven Harold Deters |
First Address | Greenville, NC 27858-9780 |
Second Address | Greenville, NC 27834-4532 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0351H | BLUE CROSS BLUE SHIELD (01) |