Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | APRN 20198 | SC |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | APRN 20198 | SC |
NPI | 1205281235 |
---|---|
Provider Name | Dr. William Fiebig |
First Address | Raeford, NC 28376-9111 |
Second Address | Raeford, NC 28376 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2016 |
Last Update Date | 16/03/2020 |