Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | 40433 | TN |
N | 208000000X | Pediatrician | 23116 | MS |
Y | 2080P0208X | Pediatric Infectious Diseases | 40433 | TN |
NPI | 1295981702 |
---|---|
Provider Name | Timothy Dean Minniear |
First Address | Memphis, TN 38105-4607 |
Second Address | Memphis, TN 38105-4625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2008 |
Last Update Date | 14/08/2020 |