Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD-36924 | TN |
NPI | 1184616369 |
---|---|
Provider Name | Shawn Patrick Stallings |
First Address | Smyrna, TN 37167-5688 |
Second Address | Smyrna, TN 37167-5688 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 27/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3879535 | (05) | TN |
H18196 | (02) |