Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 200200143 | NC |
NPI | 1073510848 |
---|---|
Provider Name | William Miller |
First Address | Clyde, NC 28721-7430 |
Second Address | Clyde, NC 28721-7430 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 16/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
132WC | BLUE CROSS NC (01) | NC |
2010773 | (02) | NC |
89132WC | (05) | NC |