Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 2016-00789 | NC |
N | 208G00000X | Cardiothoracic Vascular Surgeon | LL32969 | SC |
NPI | 1114238755 |
---|---|
Provider Name | Dr. Walter F Denino |
First Address | Charlotte, NC 28263-3362 |
Second Address | Durham, NC 27705-4699 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2010 |
Last Update Date | 13/06/2016 |