Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 052234 | GA |
N | 111NI0900X | Internist | 052234 | GA |
N | 207RG0300X | Geriatric Medicine | 052234 | GA |
Y | 207RN0300X | Nephrologist | 052234 | GA |
NPI | 1073538088 |
---|---|
Provider Name | Navin Taneja |
First Address | Warner Robins, GA 31088-4204 |
Second Address | Warner Robins, GA 31088-4204 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 24/09/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000980482D | (05) | GA |
000980482F | (05) | GA |
H78354 | (02) | GA |