Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 37849 | TN |
NPI | 1285637462 |
---|---|
Provider Name | Dr. Lama Ma Elbahlawan |
First Address | Memphis, TN 38105-3678 |
Second Address | Memphis, TN 38105-3678 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 28/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009971325 | (05) | AL |
08958791 | (05) | MS |
1470881 | (05) | LA |
154139001 | (05) | AR |
200077380A | (05) | OK |
200379190A | (05) | KS |
200512820A | (05) | IN |
208967505 | (05) | MO |
422400000 | (05) | ME |
5440117 | (05) | TN |
64082142 | (05) | KY |
I20632 | (02) | TN |