Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 38810 | TN |
Y | 2080P0210X | Pediatric Nephrologist | 38810 | TN |
NPI | 1487675831 |
---|---|
Provider Name | Mihail Marius Subtirelu |
First Address | Knoxville, TN 37901-5004 |
Second Address | Knoxville, TN 37916-2220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 21/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I38498 | (02) | TN |
Q003971 | (05) | TN |