Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 23233 | GA |
NPI | 1114922267 |
---|---|
Provider Name | Nancy W Stead |
First Address | Gainesville, GA 30501-1210 |
Second Address | Gainesville, GA 30501-1210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 03/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D30908 | (02) |