MEDICARE: ANDREW AVERY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	208600000X	Surgery Physician	57168	TN

General Provider Information

NPI Number	:	1164841730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW AVERY MD

Provider Business Mailing Address
First Line	:	719 THOMPSON LN STE 30330
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37204-4701
Country	:	US
Telephone Number	:	615-322-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3601 THE VANDERBILT CLINIC
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37232-2730
Country	:	US
Telephone Number	:	615-322-3000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2014
Last Update Date	:	10/15/2020

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