| 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 |