Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 2019-02836 | NC |
NPI | 1073952974 |
---|---|
Provider Name | Michael A Bohl |
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 | 24/06/2013 |
Last Update Date | 21/12/2020 |