Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 9600785 | NC |
NPI | 1043236318 |
---|---|
Provider Name | Robert Yavorski |
First Address | Charlotte, NC 28204-2963 |
Second Address | Charlotte, NC 28204-2963 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 12/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G29950 | (02) |