Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0106X | Orthopaedic Hand Surgeon | 28074 | TN |
Y | 2086S0105X | Surgery of the Hand | MD28074 | TN |
NPI | 1689670952 |
---|---|
Provider Name | Dr. Robert Daniel Mastey |
First Address | Chattanooga, TN 37404-3322 |
Second Address | Chattanooga, TN 37404-3322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2005 |
Last Update Date | 07/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3807567 | (05) | TN |
G25921 | (02) | TN |