Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD26680 | TN |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | MD26680 | TN |
N | 2086S0105X | Surgery of the Hand | MD26680 | TN |
NPI | 1619961976 |
---|---|
Provider Name | Mr. Martin J Fiala |
First Address | Tullahoma, TN 37388-2222 |
Second Address | Tullahoma, TN 37388-2222 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2005 |
Last Update Date | 07/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0940299 | UNITED HEALTH CARE (01) | |
10070490 | AMERIGROUP (01) | TN |
1536928 | UMWA (01) | |
200034386 | RAILROAD MEDICARE (01) | |
3093522 | BLUE CROSS (01) | TN |
3098802 | (05) | TN |
3098803 | (02) | |
5541521 | CIGNA (01) | |
621738887002 | PRUDENTIAL (01) | |
682362 | AETNA (01) | |
G23500 | (02) | |
TN0102 | AMERICHOICE (01) | TN |