Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 9500198 | NC |
NPI | 1083674428 |
---|---|
Provider Name | Theodore Braneh Rheney JR. |
First Address | Asheville, NC 28803 |
Second Address | Asheville, NC 28803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2006 |
Last Update Date | 07/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7971410 | (05) | NC |
G01358 | (02) |