Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 224P00000X | Prosthetist | ||
Y | 224P00000X | Prosthetist | NC | |
N | 225000000X | Orthotic Fitter | ||
N | 225000000X | Orthotic Fitter | NC |
NPI | 1063618791 |
---|---|
Provider Name | Mr. William M Truesdale |
First Address | New Bern, NC 28563-1481 |
Second Address | New Bern, NC 28562-2846 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2007 |
Last Update Date | 23/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7795009 | (05) | NC |