Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP1101X | Primary Podiatric Medicine | DPM608 | TN |
Y | 213ES0103X | Foot & Ankle Surgery | DPM608 | TN |
NPI | 1588616098 |
---|---|
Provider Name | Dr. Mark B Hellmann |
First Address | Harriman, TN 37748-8331 |
Second Address | Harriman, TN 37748-8331 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 09/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3353920 | (05) | TN |
4127674 | BCBS TN (01) | TN |
P00363617 | RAILROAD MEDICARE (01) | TN |
U91018 | (02) | TN |