Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | MD15320 | TN |
NPI | 1659340610 |
---|---|
Provider Name | Dr. Marek M Pienkowski |
First Address | Knoxville, TN 37919-5606 |
Second Address | Knoxville, TN 37919-5606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 12/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0030601 | BCBSTN (01) | TN |
0056936 | BCBSTN (01) | TN |
0166234 | BCBSTN (01) | TN |
0202905 | BCBSTN (01) | TN |
059803 | BCBSVA (01) | VA |
064686 | BCBSVA (01) | VA |
067080 | BCBSVA (01) | VA |
2004413 | BCBSTN (01) | TN |
3006450 | (05) | TN |
3006456 | (05) | TN |
3006457 | (05) | TN |
3006458 | (05) | TN |
30065459 | (05) | TN |
B58833 | (02) | TN |