Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 37738 | TN |
NPI | 1083603906 |
---|---|
Provider Name | Paul Cornea |
First Address | Chattanooga, TN 37404-1163 |
Second Address | Chattanooga, TN 37404-1163 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2005 |
Last Update Date | 02/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H92236 | (02) | TN |