Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 0101-231281 | VA |
Y | 2080P0214X | Pediatric Pulmonologist | 0101-231281 | VA |
NPI | 1003888900 |
---|---|
Provider Name | Joseph Tamez |
First Address | Roanoke, VA 24018-4603 |
Second Address | Roanoke, VA 24018-0720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2006 |
Last Update Date | 05/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003888900 | (05) | VA |
6720528 | (05) | VA |
H45636 | (02) | VA |