Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 11536 | MS |
NPI | 1033142724 |
---|---|
Provider Name | Nouhad O Kronfol |
First Address | Greenville, MS 38703-7268 |
Second Address | Greenville, MS 38703-7268 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2006 |
Last Update Date | 14/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0016033 | (05) | MS |
390000044 | MEDICARE (01) | MS |
B64696 | (02) |