Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 2013-00244 | NC |
N | 2084N0402X | Child Neurologist | 24041 | SC |
NPI | 1093751471 |
---|---|
Provider Name | Timothy Scott Livingston |
First Address | Charlotte, NC 28260-2344 |
Second Address | Concord, NC 28025-2948 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 27/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1093751471 | (05) | NC |
T83745 | (05) | SC |