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Individual

LAURENTIA NODIT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1924 ALCOA HWY, UT HOSPITAL, KNOXVILLE, TN 37920-1511
(865) 305-9080
Mailing address
PO BOX 52450, KNOXVILLE, TN 37950-2450
(865) 305-9080

Taxonomy

Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
MD0000040729
TN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD0000040729
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1516608
TN
05
33386101
TN
01
4129292
BCBS
TN
05
7100040300
KY
Enumeration date
03/22/2006
Last updated
09/01/2010
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