Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 0101059083 | VA |
NPI | 1003817552 |
---|---|
Provider Name | Robert C Kime III |
First Address | Harrisonburg, VA 28801-3576 |
Second Address | Harrisonburg, VA 28801-3576 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2005 |
Last Update Date | 19/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006407064 | (05) | VA |
326640 | ANTHEM (01) | |
366452 | CIGNA (01) | |
688842 | CIGNA (01) | |
F77306 | (02) |