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1730126574

NPI Code Detail

MEDICARE: DR. FERNANDO S. ESTRELLA MD

MEDICARE: DR. FERNANDO S. ESTRELLA 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	207R00000X	Internal Medicine Physician	43817	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	C04388	OTHER		MEDICARE GROUP #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	197245	OTHER	VA	ANTHEM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730126574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FERNANDO S. ESTRELLA MD

Provider Business Mailing Address
First Line	:	4321 CAROTHERS PARKWAY
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067
Country	:	US
Telephone Number	:	615-435-6690
Fax Number	:	615-435-7320

Provider Business Practice Location Address
First Line	:	4321 CAROTHERS PKWY
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-5909
Country	:	US
Telephone Number	:	615-435-6690
Fax Number	:	615-435-7320

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

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	06/22/2010

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Directions to “ DR. FERNANDO S. ESTRELLA MD” Practice Location

Language	Start Address	Practice Location

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