Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 2007-00980 | NC |
Y | 208600000X | Surgeon | 2007-00980 | NC |
N | 208200000X | Surgeon | 20321 | SC |
N | 208600000X | Surgeon | 20321 | SC |
N | 208200000X | Surgeon | 23188 | NE |
N | 208600000X | Surgeon | 23188 | NE |
NPI | 1023089109 |
---|---|
Provider Name | James Michael Egbert |
First Address | Washington, NC 27889 |
Second Address | Washington, NC 27889 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 14/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
891452F | (05) | NC |