Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 36711 | NC |
Y | 208600000X | Surgeon | 36711 | NC |
NPI | 1013991744 |
---|---|
Provider Name | Dr. Todd M Gerkin |
First Address | Greensboro, NC 27401-1439 |
Second Address | Greensboro, NC 27401-1439 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2005 |
Last Update Date | 05/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
893511K | (05) | NC |
F56326 | (02) | NC |