Individual
DR. CORNELIUS MCKOWN DYKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2555 COURT DR, SUITE 200, GASTONIA, NC 28054-2134
(704) 671-7670
(704) 671-7672
Mailing address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2331
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
11686
ND
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
9800242
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891127W
—
NC
05
—
N00243
—
SC
01
—
P00223121
RAILROAD MEDICARE
NC
Enumeration date
09/27/2005
Last updated
09/26/2013
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