Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | 11404 | TN |
Y | 208000000X | Pediatrician | 11404 | TN |
NPI | 1265432488 |
---|---|
Provider Name | Dr. Narayanaswami Rangaswami |
First Address | Memphis, TN 38103-2807 |
Second Address | Memphis, TN 38107-2805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2005 |
Last Update Date | 25/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B59386 | (02) | TN |