Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 32664 | NC |
Y | 207RP1001X | Pulmonary Disease | 32664 | NC |
NPI | 1053396481 |
---|---|
Provider Name | Robert Chin JR. |
First Address | Winston Salem, NC 27103-4007 |
Second Address | Winston Salem, NC 27103-4007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2005 |
Last Update Date | 08/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
197834000 | (05) | WV |
22354 | BCBS (01) | NC |
37223 | MEDCOST (01) | NC |
4198 | PARTNERS (01) | NC |
5644077 | AETNA (01) | NC |
6050646 | (05) | VA |
8922354 | (05) | NC |
D05388 | (02) | |
Q32664 | (05) | SC |