Frederick Walter Gourdin
MOHS-Micrographic Surgeon
78 Long Shoals Rd
Arden
, North Carolina 28704-7782
Frederick Walter Gourdin
MOHS-Micrographic Surgeon
78 Long Shoals Rd
Arden
, North Carolina 28704-7782
(828) 684-5344
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About
Features
Specialties
- MOHS-Micrographic Surgeon
Languages spoken
- English
Location
First Address
- Frederick Walter Gourdin
- 78 Long Shoals Rd
- Arden, NC
- Zip : 28704-7782
- Fax : (828) 684-5344
- Phone : (828) 684-0703
Second Address
- Frederick Walter Gourdin
- 78 Long Shoals Rd
- Arden, NC
- Zip : 28704-7782
- Fax : (828) 684-5344
- Phone : (828) 684-0703
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207ND0101X | MOHS-Micrographic Surgeon | 9800549 | NC |
National Provider Identifier
| NPI | 1215902663 |
|---|---|
| Provider Name | Frederick Walter Gourdin |
| First Address | Arden, NC 28704-7782 |
| Second Address | Arden, NC 28704-7782 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/02/2006 |
| Last Update Date | 09/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 8911375 | (05) | NC |
| B04230 | (02) | NC |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.