Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 22548 | NC |
NPI | 1043250590 |
---|---|
Provider Name | William R Berry |
First Address | Raleigh, NC 27609-7620 |
Second Address | Raleigh, NC 27607-6319 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 03/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8915198 | (05) | NC |
C82808 | (02) | NC |