Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 0020737 | NC |
NPI | 1013956846 |
---|---|
Provider Name | John T Klimas |
First Address | Charlotte, NC 28263-3376 |
Second Address | Charlotte, NC 28204-4375 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 26/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
137747 | (05) | SC |
8949672 | (05) | NC |
C84951 | (02) |