Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0101X | MOHS-Micrographic Surgeon | MD35480 | TN |
N | 207ND0900X | Dermatopathologist | MD35480 | TN |
N | 207NS0135X | Procedural Dermatology | MD35480 | TN |
NPI | 1215904602 |
---|---|
Provider Name | Ms. Amy A Huber |
First Address | Memphis, TN 38104-6727 |
Second Address | Memphis, TN 38104-6727 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2006 |
Last Update Date | 04/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H88211 | (02) |