Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 60884 | TN |
NPI | 1043651318 |
---|---|
Provider Name | Andrea Joan Cuviello |
First Address | Memphis, TN 38105-3678 |
Second Address | Memphis, TN 38105-3678 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2013 |
Last Update Date | 08/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D81732 | STATE LICENSE (01) | MD |