Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | DPM00583 | TN |
NPI | 1306825211 |
---|---|
Provider Name | I Cliff Retief |
First Address | Nashville, TN 37211-4854 |
Second Address | Nashville, TN 37211-4854 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2006 |
Last Update Date | 09/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3376588 | (05) | TN |