Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 22506 | WV |
Y | 2080P0210X | Pediatric Nephrologist | 22506 | WV |
NPI | 1124128996 |
---|---|
Provider Name | Dr. Ali Mirza Onder |
First Address | Memphis, TN 38105 |
Second Address | Memphis, TN 38105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 16/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3810006231 | (05) | WV |
I59345 | (02) |