Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 93-00391 | NC |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 93-00391 | NC |
N | 207VG0400X | Gynecologist | 9300391 | NC |
NPI | 1518931161 |
---|---|
Provider Name | James P Theofrastous |
First Address | Asheville, NC 28806-2343 |
Second Address | Asheville, NC 28806-2343 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2006 |
Last Update Date | 10/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0770757 | UNITED HEALTHCARE (01) | |
82474 | BC BS NC (01) | |
8982474 | (05) | NC |