Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | ||
Y | 222Z00000X | Podiatrist | ||
N | 224P00000X | Prosthetist |
NPI | 1336586080 |
---|---|
Provider Name | Mr. Charles Steven Woolfe |
First Address | Raleigh, NC 27609-7400 |
Second Address | Raleigh, NC 27609-7400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2013 |
Last Update Date | 03/06/2013 |