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Individual

ELAINE S AMBERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1803 MOWBRAY PIKE, SODDY DAISY, TN 37379-7109
(423) 710-4716
Mailing address
PO BOX 70, SODDY DAISY, TN 37384-0070
(423) 710-4716

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
MD14930
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3138635
BCBS
TN
Enumeration date
08/31/2006
Last updated
02/25/2014
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