Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 0101250045 | VA |
Y | 2080P0202X | Pediatric Cardiologist | 54765 | TN |
NPI | 1215224712 |
---|---|
Provider Name | Govinda Paudel |
First Address | Memphis, TN 38103-2802 |
Second Address | Memphis, TN 38103-2816 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2011 |
Last Update Date | 25/08/2016 |