Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | MD013367 | TN |
NPI | 1083675706 |
---|---|
Provider Name | David P Lurie |
First Address | Johnson City, TN 37604-5977 |
Second Address | Johnson City, TN 37604-5977 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2006 |
Last Update Date | 26/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1083675706 | (05) | TN |
1083675706 | NPI (01) | TN |
3185528 | (05) | TN |
B04194 | (02) | TN |