Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 1955 | NC |
NPI | 1043265531 |
---|---|
Provider Name | Mr. George Crosby III |
First Address | Charlotte, NC 28207-1100 |
Second Address | Charlotte, NC 28207-1100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 16/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0775B | BCBS (01) | NC |
186635 | MEDCOST (01) | NC |
2143186 | MAMSI (01) | NC |
4572849 | AETNA (01) | NC |
807114 | PARTNERS (01) | NC |