Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | 3759 | NC |
NPI | 1194784272 |
---|---|
Provider Name | Dr. William A Streiff |
First Address | Salisbury, NC 28144 |
Second Address | Salisbury, NC 28144 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8998151 | (05) | NC |
98151 | BLUE CROSS BLUE SHIELD (01) | NC |
T63782 | (02) |