Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD13138 | TN |
NPI | 1073619888 |
---|---|
Provider Name | Dr. Vijay R. Patil |
First Address | Knoxville, TN 37916-1810 |
Second Address | Knoxville, TN 37916-1810 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 29/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
13955 | BCBS TN (01) | TN |
3161878 | (05) | TN |
406332082 | (02) | TN |
B59295 | (02) | TN |