Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 200501926 | NC |
Y | 208600000X | Surgeon | 200501926 | NC |
N | 2086S0105X | Surgery of the Hand | 200501926 | NC |
NPI | 1194749648 |
---|---|
Provider Name | Sanford William Hawkins-Rivers |
First Address | Dunn, NC 28334-5509 |
Second Address | Dunn, NC 28334-5509 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 25/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1414K | BC/BS (01) | NC |
193562 | MEDCOST (01) | NC |
2005-01926 | NC LICENSE (01) | NC |
5903407 | (05) | NC |
I03666 | (02) |