Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 94-00095 | NC |
NPI | 1003990912 |
---|---|
Provider Name | Shu Lin |
First Address | Durham, NC 27710-4000 |
Second Address | Lumberton, NC 28358-3019 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 18/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
891366M | (05) | NC |
I08893 | (02) |