Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 21530 | NC |
NPI | 1043200371 |
---|---|
Provider Name | John Spencer Atwater |
First Address | Charlotte, NC 28260-3725 |
Second Address | Asheville, NC 28801-4104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2005 |
Last Update Date | 10/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8912170 | (05) | NC |
C85446 | (02) |