Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 470 | NC |
NPI | 1063401164 |
---|---|
Provider Name | Dr. William David Respess |
First Address | Greenville, NC 27858-5466 |
Second Address | Greenville, NC 27858-5466 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2005 |
Last Update Date | 21/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0808V | BLUE CROSS BLUE SHEILD (01) | NC |
4699540001 | SUPPLIER IDENTIFIER (01) | NC |
890808V | (05) | NC |
U90295 | (02) | NC |