Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 200501770 | NC |
NPI | 1174561179 |
---|---|
Provider Name | Michael T Tooke |
First Address | Greensboro, NC 27415-4924 |
Second Address | Greensboro, NC 27401-1038 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 13/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5903072 | (05) | NC |
A85014 | (02) |