Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | NC |
NPI | 1013950377 |
---|---|
Provider Name | Mr. Peter Edward Babcock |
First Address | Charlotte, NC 28289-0195 |
Second Address | Greensboro, NC 27403-1127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
187568 | MEDCOST (01) | NC |
7003794 | (05) | NC |
Q68103 | (02) |