Organization
THE WALTER E. BOEHM BIRTH DEFECTS CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARREE STOKER (EXECUTIVE DIRECTOR)
(423) 778-2222
Entity
Organization
Contact information
Practice address
910 BLACKFORD ST, CHATTANOOGA, TN 37403-1405
(423) 778-2222
(423) 778-6191
Mailing address
975 E 3RD ST, CHATTANOOGA, TN 37403-2103
(423) 778-2222
(423) 778-6191
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4094742
BCBS OF TENNESSEE
TN
05
—
5903251
—
NC
Enumeration date
10/24/2006
Last updated
08/22/2020
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