Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 33706 | NC |
NPI | 1013990019 |
---|---|
Provider Name | Frederick Arthur Lupton III |
First Address | Greensboro, NC 27415-4994 |
Second Address | Greensboro, NC 27405-6933 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2005 |
Last Update Date | 29/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
070015164 | MEDICARE RAILROAD (01) | NC |
53282 | BCBS (01) | |
562221469 | UHC/CIGNA/FIRST HEALTH (01) | |
8953282 | (05) | NC |
E75672 | (02) |