Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD29355 | TN |
N | 208600000X | Surgeon | MD29355 | TN |
Y | 2086X0206X | Surgical Oncologist | MD29355 | TN |
N | 208C00000X | Colorectal Surgeon | MD29355 | TN |
NPI | 1033226162 |
---|---|
Provider Name | Dr. Gregory Panos Midis |
First Address | Knoxville, TN 37950-2948 |
Second Address | Knoxville, TN 37916-2435 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 10/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3811050 | (05) | TN |
E57436 | (02) |