Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 33669 | NC |
NPI | 1043346570 |
---|---|
Provider Name | Robert Gordon Graper |
First Address | Charlotte, NC 28211 |
Second Address | Charlotte, NC 28211 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 08/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7936801 | (05) | NC |
B87946 | (02) |