Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 50666 | TN |
NPI | 1205047727 |
---|---|
Provider Name | Ying Zhuge Weatherall |
First Address | Memphis, TN 38105-4607 |
Second Address | Memphis, TN 38105-4625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 10/12/2018 |