Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 200000799 | NC |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 200000799 | NC |
NPI | 1891749511 |
---|---|
Provider Name | Dr. William M Geideman |
First Address | Charlotte, NC 28209-3239 |
Second Address | Hickory, NC 28602-1363 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 13/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
89126WJ | (05) | NC |
BG6440692 | DEA NUMBER (01) | NC |
H00604 | (02) | NC |