Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | MD42387 | TN |
NPI | 1093918252 |
---|---|
Provider Name | Mary Elizabeth Romano |
First Address | Nashville, TN 37232-8678 |
Second Address | Nashville, TN 37232-5100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2007 |
Last Update Date | 17/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
620476822 | VMG TAX ID (01) | TN |