Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 0050-01809 | NC |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 0050-01809 | NC |
NPI | 1003913005 |
---|---|
Provider Name | William Michael Scott |
First Address | Durham, NC 27704-2121 |
Second Address | Durham, NC 27705-6006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2008 |