Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | NC |
NPI | 1003824889 |
---|---|
Provider Name | Yuri Anthony Fesko |
First Address | Durham, NC 27704-2121 |
Second Address | Durham, NC 27704-2121 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 04/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BF9305865 | DEA (01) |