Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 9900350 | NC |
N | 207NS0135X | Procedural Dermatology | 9900350 | NC |
NPI | 1033104369 |
---|---|
Provider Name | Gina Rae Singleton |
First Address | Clyde, NC 28721-1900 |
Second Address | Asheville, NC 28806-5000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 03/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1195T | BLUE CROSS BLUE SHIELD (01) | |
561473220 | ALL OTHER INSURANCE (01) | |
891195T | (05) | NC |
G88400 | (02) |