Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301100306 | MI |
N | 2080P0207X | Pediatric Hematology-Oncologist | 4301100306 | MI |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 61595 | TN |
NPI | 1265887467 |
---|---|
Provider Name | Aditi Bagchi |
First Address | Memphis, TN 38105-3678 |
Second Address | Memphis, TN 38105-3678 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2016 |
Last Update Date | 19/06/2020 |