NPI | 1639190846 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL S DEW Doctor 423-224-4183 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: TN MD26480) |
Additional Taxonomies | 174400000X Specialist (Licence: TN MD20022) |
Enumeration Date | 2006-07-22 |
Last Update Date | 2020-08-22 |