Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 30150 | NC |
NPI | 1003975285 |
---|---|
Provider Name | Mr. Robert Braden Dunmire III |
First Address | Goldsboro, NC 27534-1647 |
Second Address | Goldsboro, NC 27534-1647 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 21/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8929424 | (05) | NC |
E86156 | (02) |