Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 29260 | TN |
NPI | 1508869793 |
---|---|
Provider Name | Dr. Andrew M. Davidoff |
First Address | Memphis, TN 38105-3678 |
Second Address | Memphis, TN 38105-3678 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 05/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00118708 | (05) | MS |
009914190 | (05) | AL |
0149566 | (05) | MT |
036093610-3 | (05) | IL |
0527846 | (05) | IA |
100016910A | (05) | OK |
104802025 | (05) | MI |
133131001 | (05) | AR |
1549606 | (05) | LA |
200110730A | (05) | IN |
200377030A | (05) | KS |
2033963 | (05) | OH |
205026701 | (05) | MO |
3818503 | (05) | TN |
422400000 | (05) | ME |
64927858 | (05) | KY |
6514201 | (05) | NJ |
7612100 | (05) | NC |
G04674 | (02) | TN |