Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 25574 | KY |
Y | 2080P0214X | Pediatric Pulmonologist | 25574 | KY |
NPI | 1235113192 |
---|---|
Provider Name | Nemr S Eid |
First Address | Chicago, IL 60677-6879 |
Second Address | Louisville, KY 40202-1713 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2005 |
Last Update Date | 10/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100376780 | (05) | IN |
64255748 | (05) | KY |
A63503 | (02) |