Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 572 | NC |
N | 222Z00000X | Podiatrist | 572 | NC |
Y | 213EP1101X | Primary Podiatric Medicine | 572 | NC |
N | 213ES0103X | Foot & Ankle Surgery | 572 | NC |
NPI | 1487815684 |
---|---|
Provider Name | Eric G Simmons |
First Address | Raleigh, NC 27612-5243 |
Second Address | Raleigh, NC 27612-5243 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2008 |
Last Update Date | 06/05/2021 |