Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 38851 | TN |
Y | 2086S0129X | Vascular Surgeon | 38851 | TN |
NPI | 1366550014 |
---|---|
Provider Name | Oscar H. Grandas |
First Address | Nashville, TN 37244-0265 |
Second Address | Knoxville, TN 37920 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 06/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1517043 | (05) | TN |
H31517 | (02) | TN |