Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 2018-02063 | NC |
N | 207X00000X | Orthopaedic Surgeon | 269962 | MA |
N | 208200000X | Surgeon | 173880 | NC |
N | 208600000X | Surgeon | 173880 | NC |
NPI | 1013203470 |
---|---|
Provider Name | Paul Michael Lichstein |
First Address | Charlotte, NC 28260-0447 |
Second Address | Salisbury, NC 28144 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2011 |
Last Update Date | 25/10/2020 |