Provider Demographics
NPI:1669562138
Name:FIRNHABER, JUAN B (MD)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:B
Last Name:FIRNHABER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2430 EMERALD PL STE 201
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-5743
Mailing Address - Country:US
Mailing Address - Phone:252-752-2140
Mailing Address - Fax:
Practice Address - Street 1:2430 EMERALD PL STE 201
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5743
Practice Address - Country:US
Practice Address - Phone:252-752-2140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-00503207LP2900X, 207L00000X, 207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC158UUOtherBCBS OF NC
NC1669562138OtherTRICARE
NC5914302Medicaid
NCP00829636OtherRR MEDICARE
NC231593OtherMEDCOST
NCP00829636OtherRR MEDICARE
NC1669562138OtherTRICARE