Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 20071498 | NC |
NPI | 1063440634 |
---|---|
Provider Name | John M Lesher |
First Address | Charlotte, NC 28204-3109 |
Second Address | Charlotte, NC 28204-3109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2006 |
Last Update Date | 17/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I57312 | (02) | |
P00450241 | RAILROAD MEDICARE (01) |