| NPI | 1639894397 |
|---|---|
| Doing Business As | UNIVERSITY NEUROINTERVENTIONAL RADIOLOGY |
| Entity Type | Organization |
| Authorized Contact | CAROL A BURGESS Provider Enrollment Team Lead 865-670-6754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2022-10-05 |
| Last Update Date | 2022-10-28 |