Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 40192 | TN |
NPI | 1003963802 |
---|---|
Provider Name | Dr. Michael Warren |
First Address | Nashville, TN 37232-0005 |
Second Address | Nashville, TN 37232-0005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 21/12/2009 |