Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 9400768 | NC |
NPI | 1013956457 |
---|---|
Provider Name | Peter G Dalldorf |
First Address | Greensboro, NC 27408-7033 |
Second Address | Greensboro, NC 27408-7033 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 26/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7926773 | (05) | NC |
F63405 | (02) |