Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 9801499 | NC |
NPI | 1306828207 |
---|---|
Provider Name | Timothy C. Sloan |
First Address | New Bern, NC 28561-2065 |
Second Address | New Bern, NC 28562-5238 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2005 |
Last Update Date | 29/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
131H4 | BCBS OF NC (01) | NC |
149541 | VYTRA (01) | NC |
153000500 | DOL (01) | NC |
760158 | MAMSI (01) | NC |
89131H4 | (05) | NC |
C7539 | MEDCOST (01) | NC |
H67359 | (02) | NC |