Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | MD014218 | TN |
NPI | 1013905322 |
---|---|
Provider Name | Richard C Tomichek |
First Address | Nashville, TN 37205-2013 |
Second Address | Nashville, TN 37205-2013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3196243 | (05) | TN |
B04702 | (02) |