Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | MD41548 | TN |
NPI | 1003804204 |
---|---|
Provider Name | Saji Eapen |
First Address | Knoxville, TN 37915-2566 |
Second Address | Knoxville, TN 37909-1327 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2005 |
Last Update Date | 28/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010081416 | (05) | VA |
010081424 | (05) | VA |
2101404 | UNITED HEALTHCARE (01) | |
282529 | AMERIGROUP (01) | |
3128998 | MAMSI OPT CHOICE (01) | |
3607654 | AETNA HMO (01) | |
61960002 | BCBS CAREFIRST (01) | |
683237 | NCPPO (01) | |
7013613 | AETNA PPO (01) | |
H30272 | (02) |