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General NPI Number Information
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NPI Number | 1982090957
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Entity Type | Individual
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Provider Name | JONATHAN TORRES
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Gender | Male
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Dates
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Enumeration Date | 04/07/2015
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Last Update Date | 04/09/2022
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Provider Practice Location Address
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Address Line | 557 BROOKDALE DR
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City | STATESVILLE
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State | NC
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Zip | 28677-4107
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Country | US
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Telephone | 704-437-0429
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Fax |
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Provider Business Mailing Address
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Address Line | 557 BROOKDALE DR
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City | STATESVILLE
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State | NC
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Zip | 28677-4107
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 2021-03229
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License Number State | NC
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