Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 1573 | TN |
NPI | 1518077718 |
---|---|
Provider Name | Dr. Suman Chaudhuri |
First Address | Nashville, TN 37204-3126 |
Second Address | Nashville, TN 37204-3126 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 15/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V11956 | (02) | TN |