Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 425 | NC |
N | 213ES0103X | Foot & Ankle Surgery | 425 | NC |
N | 213ES0131X | Foot Surgery | 425 | NC |
NPI | 1326048661 |
---|---|
Provider Name | Martha J Ajlouny |
First Address | Concord, NC 28025-0112 |
Second Address | Greensboro, NC 27403-1153 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 17/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U81337 | (02) | NC |