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Individual

NINO BOALS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
877 JEFFERSON AVE, MEMPHIS, TN 38103-2807
(901) 448-4454
Mailing address
877 JEFFERSON AVE, MEMPHIS, TN 38103-2807
(901) 448-4454

Taxonomy

Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
238762
MA
2085N0700X
Neuroradiology Physician
Primary
47060
TN
2085R0202X
Diagnostic Radiology Physician
N6859
TX

Other

Enumeration date
02/04/2009
Last updated
11/11/2016
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