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Individual
NAM DAI VO
Active
Individual
NAM DAI VO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
200401147
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
143GY
NC BLUE CROSS PROVIDER #
NC
05
—
5904808
—
NC
Enumeration date
05/15/2006
Last updated
06/30/2010
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