Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD13349 | TN |
N | 208600000X | Surgeon | MD13349 | TN |
N | 2086S0122X | Plastic and Reconstructive Surgery | MD13349 | TN |
NPI | 1043316821 |
---|---|
Provider Name | Dr. Dan Huff Shell III |
First Address | Memphis, TN 38119-4712 |
Second Address | Memphis, TN 38119-4712 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3186141 | (05) | TN |
B58863 | (02) |