Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 27203 | NC |
NPI | 1063429322 |
---|---|
Provider Name | Robert Higgins |
First Address | Augusta, GA 30909-6520 |
Second Address | Charlotte, NC 28204-2990 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 25/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C66147 | (02) | NC |