Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 30428 | TN |
NPI | 1003813437 |
---|---|
Provider Name | Heather O Donato |
First Address | Germantown, TN 38138-1758 |
Second Address | Germantown, TN 38138-1758 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2005 |
Last Update Date | 17/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3852211 | (05) | TN |
4076399 | BCBS (01) | TN |
7740326 | AETNA (01) | |
9597876 | CIGNA (01) | |
H15698 | (02) | TN |