Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 2008027621 | MO |
Y | 208000000X | Pediatrician | MD45537 | TN |
N | 2080P0204X | Pediatric Emergency Doctor | 2008027621 | MO |
NPI | 1174612006 |
---|---|
Provider Name | Dr. Maya Kamath Neeley |
First Address | Nashville, TN 37232-0001 |
Second Address | Nashville, TN 37232-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 11/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1518012 | (05) | TN |