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NPI Code Detail

MEDICARE: CRESCENT MEDICAL GROUP PLLC

MEDICARE: CRESCENT MEDICAL GROUP PLLC
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
1207R00000XInternal Medicine Physician
2208M00000XHospitalist Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1103G709628OTHERMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649576414
Entity Type Code : Organization
Provider Name (Legal Business Name) : CRESCENT MEDICAL GROUP PLLC
Provider Business Mailing Address
First Line : 107 ASHTON PARK BLVD
Second Line :
City : FRANKLIN
State : TN
Zip : 37067-6415
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1412 COUNTY HOSPITAL RD
Second Line :
City : NASHVILLE
State : TN
Zip : 37218-3007
Country : US
Telephone Number : 615-687-2521
Fax Number :
Authorized Official
Title or Position : DR
Name : FAIZA AMIN
Credential : MD
Telephone Number : 615-807-0562
Provider Enumeration Date : 01/26/2011
Last Update Date : 04/03/2011

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