Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 200100689 | NC |
NPI | 1083644678 |
---|---|
Provider Name | Richard Ramas Gillespie |
First Address | Monroe, NC 28112-4351 |
Second Address | Charlotte, NC 28277-6660 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 01/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
89129PE | (05) | NC |