MEDICARE: DR. ANNE VICTORIA MARSALA M.D.

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	208000000X	Pediatrics Physician	BP10039677	TX
2	208000000X	Pediatrics Physician	310174	LA
3	208M00000X	Hospitalist Physician	DR.0058400	CO
4	208000000X	Pediatrics Physician	69100	TN

General Provider Information

NPI Number	:	1336434968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNE VICTORIA MARSALA M.D.

Provider Business Mailing Address
First Line	:	3841 GREEN HILLS VILLAGE DR STE 200
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2691
Country	:	US
Telephone Number	:	615-322-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3601 THE VANDERBILT CLINIC
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37232-2406
Country	:	US
Telephone Number	:	615-322-5000
Fax Number	:

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

Provider Enumeration Date	:	06/11/2011
Last Update Date	:	09/15/2023

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