Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ||
N | 222Z00000X | Podiatrist | ||
Y | 224P00000X | Prosthetist |
NPI | 1255481347 |
---|---|
Provider Name | Mr. William S. Stauffer |
First Address | Raleigh, NC 27613-1613 |
Second Address | Goldsboro, NC 27534-2257 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 21/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7795078 | (05) | NC |