Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 13913 | TN |
NPI | 1033121413 |
---|---|
Provider Name | Claudia Leonard Moise |
First Address | Memphis, TN 38148-0375 |
Second Address | Memphis, TN 38120-2367 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 22/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3013542 | (05) | TN |
A97758 | (02) | TN |
P01211194 | MEDICARE RAILROAD (01) | TN |