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 | 174400000X | Specialist | | | | No |
| 2 | 207L00000X | Anesthesiology | | | | No |
| 3 | 207Q00000X | Family Medicine | | | | No |
| 4 | 207QG0300X | Family Medicine | Geriatric Medicine | | | No |
| 5 | 207R00000X | Internal Medicine | | | | Yes |
| 6 | 207RG0100X | Internal Medicine | Gastroenterology | | | No |
| 7 | 207RN0300X | Internal Medicine | Nephrology | | | No |
| 8 | 207RP1001X | Internal Medicine | Pulmonary Disease | | | No |
| 9 | 207VF0040X | Obstetrics & Gynecology | Urogynecology and Reconstructive Pelvic Surgery | | NORTH CAROLINA | No |
| 10 | 207X00000X | Orthopaedic Surgery | | | | No |
| 11 | 207ZP0101X | Pathology | Anatomic Pathology | | | No |
| 12 | 207ZP0102X | Pathology | Anatomic Pathology & Clinical Pathology | | | No |
| 13 | 363LA2200X | Nurse Practitioner | Adult Health | | | No |
| 14 | 363LF0000X | Nurse Practitioner | Family | | | No |
| 15 | 367500000X | Nurse Anesthetist, Certified Registered | | | | No |