Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 2007-00937 | NC |
N | 1223S0112X | Oral and Maxillofacial Surgeon | 48857 | CA |
N | 1223S0112X | Oral and Maxillofacial Surgeon | S-332 | LA |
N | 204E00000X | Oral & Maxillofacial Surgeon | 200649 | LA |
N | 204E00000X | Oral & Maxillofacial Surgeon | 2007-00937 | NC |
NPI | 1023138435 |
---|---|
Provider Name | Dr. Teresa Gehret Biggerstaff |
First Address | Kernersville, NC 27284-9964 |
Second Address | Kernersville, NC 27284-9964 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2007 |
Last Update Date | 20/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
05740 | (05) | LA |
5907301 | (05) | NC |