Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 14870 | TN |
NPI | 1003803628 |
---|---|
Provider Name | Andrew H Crenshaw |
First Address | Germantown, TN 38138-2205 |
Second Address | Germantown, TN 38138-2205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2005 |
Last Update Date | 01/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00016891 | (05) | MS |
113819001 | (05) | AR |
3004908 | (05) | TN |
C48113 | (02) | TN |