Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 52034 | SC |
N | 2084N0402X | Child Neurologist | 35174 | NC |
Y | 2084N0402X | Child Neurologist | 52034 | SC |
NPI | 1104877224 |
---|---|
Provider Name | Robert A Nahouraii |
First Address | Charlotte, NC 28277-0514 |
Second Address | Columbia, SC 29203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2006 |
Last Update Date | 03/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8962907 | (05) | NC |
F42934 | (02) | |
N35174 | (05) | SC |