Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 31444 | NC |
NPI | 1083600134 |
---|---|
Provider Name | Mr. Robert D Boyd |
First Address | Hickory, NC 28603-0038 |
Second Address | Hickory, NC 28602-1385 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2005 |
Last Update Date | 11/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8917251 | (05) | NC |
AB2669399 | DEA (01) | |
C82913 | (02) |