Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 59870 | TN |
NPI | 1780849208 |
---|---|
Provider Name | Dr. Martin Ignacio Montenovo |
First Address | Nashville, TN 37215-2691 |
Second Address | Nashville, TN 37232-2420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2008 |
Last Update Date | 29/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1780849208 | (05) | WA |