Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | DPM 194 | TN |
NPI | 1386639789 |
---|---|
Provider Name | David Michael Moinester |
First Address | Memphis, TN 38119-0882 |
Second Address | Bartlett, TN 38134-3809 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 21/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3351646 | (05) | TN |
T61074 | (02) |