Doctor Name: | MR. RONELL MALEEK CONYERS |
NPI Number: | 1396146627 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LAT, ATC |
License Number: | 2421 |
Business Practice Address: | 11200 Governor Manly Way Suite 309 Raleigh, NC - 276148599 |
Business Phone Number: | 9195629410 |
Business Fax Number: | |
Mailing Address: | 11200 Governor Manly Way, Suite 309 RALEIGH |
State: | NC |
Postal Code: | 276148599 |
Phone Number: | 9195629410 |
Fax Number: | |
NPI Enumeration Date: | 09/05/2014 |
NPI Last Update Date: | 09/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 2421 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |