Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 32379 | SC |
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 28313 | OK |
NPI | 1376763276 |
---|---|
Provider Name | Trinitia Yevette Cannon |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425-0100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 06/03/2019 |