Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 24480 | NC |
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 24480 | NC |
NPI | 1346251394 |
---|---|
Provider Name | Michael Y Parker |
First Address | Wilmington, NC 28401-7307 |
Second Address | Wilmington, NC 28401-7684 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 30/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
65321 | BCBS NC (01) | NC |
8965321 | (05) | NC |
C85888 | (02) | NC |
P00253596 | RAILROAD MEDICARE (01) | NC |