Healthcare Provider Details

I. General information

NPI: 1497310528
Provider Name (Legal Business Name): MIKHAIL A HEBER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2019
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1622 WESTGATE CIR
BRENTWOOD TN
37027-8019
US

IV. Provider business mailing address

222 22ND AVE N
NASHVILLE TN
37203-1802
US

V. Phone/Fax

Practice location:
  • Phone: 629-255-2222
  • Fax: 629-255-4269
Mailing address:
  • Phone: 629-255-3486
  • Fax: 629-255-3075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number77133
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: