Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 61907 | TN |
N | 2080P0214X | Pediatric Pulmonologist | MD201708 | LA |
N | 2080P0214X | Pediatric Pulmonologist | ME89600 | FL |
NPI | 1487730156 |
---|---|
Provider Name | Fernando A Urrego |
First Address | Chattanooga, TN 37403-2102 |
Second Address | Chattanooga, TN 37403-2102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 12/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
05450710 | (05) | MS |
1019054 | (05) | LA |