Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 26606 | MS |
N | 207RC0200X | Critical Care Medicine | 58828 | TN |
Y | 207RP1001X | Pulmonary Disease | 26606 | MS |
N | 207RP1001X | Pulmonary Disease | 58828 | TN |
NPI | 1023435609 |
---|---|
Provider Name | Mr. Praneet Sivaramakrishnan Iyer |
First Address | Germantown, TN 38138-3931 |
Second Address | Southaven, MS 38671-6721 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2014 |
Last Update Date | 24/01/2022 |