Individual
DR. MAIKEL ELIA BOTROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
907 E LAMAR ALEXANDER PKWY, MARYVILLE, TN 37804-5015
(865) 977-5534
(865) 981-2154
Mailing address
PO BOX 4156, MARYVILLE, TN 37802-4156
(865) 273-1752
(865) 273-1755
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
56507
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q031884
—
TN
Enumeration date
04/08/2011
Last updated
06/03/2020
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