Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 023963 | TN |
NPI | 1174504294 |
---|---|
Provider Name | Sheng Tchou |
First Address | Johnson City, TN 37601-2049 |
Second Address | Johnson City, TN 37601-2049 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3086162 | (05) | TN |
3105211 | BC/BS (01) | |
C66099 | (02) |