Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 26022 | NC |
NPI | 1043205743 |
---|---|
Provider Name | Walter Dennis Kohut |
First Address | Greensboro, NC 27408-7128 |
Second Address | Greensboro, NC 27408-7128 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2005 |
Last Update Date | 29/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8901670 | (05) | NC |
8950004 | (05) | NC |
E16417 | (02) | NC |