Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 0220 | NC |
NPI | 1104344241 |
---|---|
Provider Name | Moamen E Sheba |
First Address | Greenville, NC 27834-5925 |
Second Address | Greenville, NC 27834-5925 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2017 |
Last Update Date | 16/07/2020 |