Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 036100454 | IL |
NPI | 1346291853 |
---|---|
Provider Name | Dr. Ramin Alemzadeh |
First Address | Memphis, TN 38105-4625 |
Second Address | Memphis, TN 38105-4625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 20/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000018515N | HUMANA (01) | |
036100454 | (05) | IL |
32505000 | (05) | WI |
F23400 | (02) |