Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 178594 | AK |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 30786 | TN |
NPI | 1033183462 |
---|---|
Provider Name | Brenda Shome |
First Address | Signal Mountain, TN 37377-0763 |
Second Address | Chattanooga, TN 37402-1226 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 12/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H12839 | (02) |