Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 200101283 | NC |
N | 208200000X | Surgeon | 200101283 | NC |
N | 208600000X | Surgeon | 200101283 | NC |
N | 2086S0102X | Surgical Critical Care | 200101283 | NC |
NPI | 1346226966 |
---|---|
Provider Name | Robert Joseph Stratta |
First Address | Winston Salem, NC 27102-0344 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2005 |
Last Update Date | 12/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
129YV | BCBS (01) | |
2004522000 | (05) | WV |
20052073 | RR MEDICARE (01) | |
43809 | PARTNERS (01) | |
7312199 | (05) | VA |
7996330 | AETNA (01) | |
89129YV | (05) | NC |
B0446 | MEDCOST (01) | |
B56928 | (02) |