Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 3706 | TN |
N | 111NI0900X | Internist | 3706 | TN |
NPI | 1003262593 |
---|---|
Provider Name | David Shved |
First Address | Chattanooga, TN 37403-2147 |
Second Address | Chattanooga, TN 37403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2016 |
Last Update Date | 30/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003262593 | OTHER (01) | FL |
3706 | MEDICAL LICENSE (01) | TN |