Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | ME94793 | FL |
NPI | 1003842071 |
---|---|
Provider Name | William Bonlore Ferguson |
First Address | Palm Coast, FL 32164-5981 |
Second Address | Palm Coast, FL 32164-5981 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 19/02/2009 |