Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 16429 | NC |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 16429 | NC |
NPI | 1093797789 |
---|---|
Provider Name | Dr. William Guerrant Moorefield JR. |
First Address | Charlotte, NC 28209-3239 |
Second Address | Charlotte, NC 28210-8538 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2005 |
Last Update Date | 04/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
89610555 | (05) | NC |
C85637 | (02) | NC |
N16429 | (05) | SC |