Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 9901532 | NC |
NPI | 1124054135 |
---|---|
Provider Name | John Giusto |
First Address | Chapel Hill, NC 27516 |
Second Address | Chapel Hill, NC 27516 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E71386 | (02) | NC |