Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 9900595 | NC |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 9900595 | NC |
NPI | 1023065240 |
---|---|
Provider Name | Peter G Mangone |
First Address | Asheville, NC 28801-4434 |
Second Address | Asheville, NC 28801-4402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 31/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12024 | BCBS (01) | NC |
8912024 | (05) | NC |
G82076 | (02) | NC |