Individual
DUM LIVINUS PIAWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
17 CENTRE PLAZA DR, JACKSON, TN 38305-2862
(731) 512-0104
(731) 668-7388
Mailing address
17 CENTRE PLAZA DR, JACKSON, TN 38305-2862
(731) 512-0104
(731) 668-7388
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MB09312200
NJ
207RC0000X
Cardiovascular Disease Physician
Primary
3284
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396033379
NPI
TN
05
—
Q028999
—
TN
Enumeration date
06/15/2010
Last updated
07/20/2021
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