Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 56164 | TN |
NPI | 1003236837 |
---|---|
Provider Name | Marthinus Theunis Zeeman |
First Address | Memphis, TN 38119-6303 |
Second Address | Oakland, TN 38060 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2014 |
Last Update Date | 01/12/2021 |