Provider Demographics
NPI:1457879785
Name:WEBB, MICHAEL (PARAMEDIC/TRANSPORT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:WEBB
Suffix:
Gender:M
Credentials:PARAMEDIC/TRANSPORT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8656 SUNNYVALE ST S
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-3518
Mailing Address - Country:US
Mailing Address - Phone:901-440-6219
Mailing Address - Fax:
Practice Address - Street 1:8656 SUNNYVALE ST S
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-3518
Practice Address - Country:US
Practice Address - Phone:901-440-6219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0343900000X
TN0000034093146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)