Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 24278 | TN |
Y | 207RP1001X | Pulmonary Disease | 24278 | TN |
NPI | 1013953918 |
---|---|
Provider Name | Christian L Stauber |
First Address | Oklahoma City, OK 73143-4670 |
Second Address | Knoxville, TN 37919 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 15/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C78440 | (02) |