Individual
MACK A LAND
Active
Individual
MACK A LAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MD8514
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00010933
—
MS
01
—
23973
BCBS OF TN
TN
05
—
3199828
—
TN
Enumeration date
07/10/2006
Last updated
02/11/2015
Update your record
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