Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 2018-00652 | NC |
N | 207Q00000X | Family Doctor | 38055 | SC |
NPI | 1003295072 |
---|---|
Provider Name | Jeffrey Richard Many |
First Address | Charlotte, NC 28260-0447 |
Second Address | Denver, NC 28037-3007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2015 |
Last Update Date | 26/10/2020 |