Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0100X | Health Service | 1179 | TN |
NPI | 1104959501 |
---|---|
Provider Name | Dr. Michael Thomas Myszka |
First Address | Nashville, TN 37209 |
Second Address | Nashville, TN 37209-3641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 08/07/2007 |