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Individual
LARRY KEITH CANTLEY
Active
Individual
LARRY KEITH CANTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
24230
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1001
PARTNERS
NC
01
—
127FN
BLUE CROSS
NC
05
—
3002077000
—
WV
01
—
4098171
AETNA
NC
05
—
5850215
—
VA
05
—
89127FN
—
NC
01
—
A0333
MEDCOST
NC
05
—
Q24230
—
SC
Enumeration date
12/08/2005
Last updated
06/27/2013
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