Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 2011-00019 | NC |
Y | 208200000X | Surgeon | 2011-00019 | NC |
Y | 208600000X | Surgeon | 2011-00019 | NC |
NPI | 1447520531 |
---|---|
Provider Name | Umar Farooq |
First Address | Charlotte, NC 28260-2658 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2012 |
Last Update Date | 05/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5919260 | (05) | NC |