Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | MD021077 | TN |
NPI | 1245297795 |
---|---|
Provider Name | Maricarmen Malagon-Rogers |
First Address | Knoxville, TN 37920-1511 |
Second Address | Knoxville, TN 37920-1511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 28/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100011932 | PHP TENNCARE (01) | TN |
1689631137 | GROUP NPI (01) | TN |
3057890 | (05) | TN |
3140062 | UNITED HEALTH CARE (01) | TN |
3373352 | UFP MEDICAID GROUP (01) | TN |
3373352 | UFP MEDICARE GROUP (01) | TN |
4036989 | BLUE CROSS/BLUE SHIELD (01) | TN |
5349187 | AETNA (01) | TN |
64922214 | (05) | KY |
7366660 | CIGNA (01) | TN |
E80528 | (02) | |
TN01H4 | JOHN DEERE (01) | TN |