Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | MD27367 | TN |
NPI | 1215907944 |
---|---|
Provider Name | Dr. Glenn A. Weitzman |
First Address | Nashville, TN 37203-1513 |
Second Address | Nashville, TN 37203-1513 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E02932 | (02) | TN |