Taxonomy Codes
                        The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
                        
                            
                                
                                    
                                        | No. | Taxonomy Code | Taxonomy Clasification | Taxonomy Specialization | License Number | License State | Primary | 
                                
                                
                                    | 1 | 2085R0001X | Radiology | Radiation Oncology | 9900334 | NORTH CAROLINA | Yes | 
                                
                            
                         
                     
                    
                        
                            Other Identifiers
                            The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
                            
                                
                                    
                                        
                                            | No. | Other Provider Identifier | Other Provider Identifier Type | Other Provider Identifier State | Other Provider Identifier Issuer | 
                                    
                                    
                                        | 1 | 1168747 | OTHER | FLORIDA | GATEWAY HEALTH | 
| 2 | 1424836010 | OTHER | NORTH CAROLINA | CIGNA PROVIDER # | 
| 3 | 891191N | MEDICAID | NORTH CAROLINA |  | 
| 4 | 4567509 | OTHER | NORTH CAROLINA | AETNA PROVIDER # | 
| 5 | A4056 | OTHER | NORTH CAROLINA | MEDCOST PROVIDER # | 
| 6 | 1191N | OTHER | NORTH CAROLINA | BCBS OF NC PROVIDER # | 
| 7 | P00046512 | OTHER | NORTH CAROLINA | RAILROAD MCARE PROVIDER # |