Healthcare Provider Details

I. General information

NPI: 1457563728
Provider Name (Legal Business Name): BENJAMIN NADEAU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 01/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 GLENWOOD DR SUITE 200
CHATTANOOGA TN
37404-1108
US

IV. Provider business mailing address

PO BOX 440100
NASHVILLE TN
37244-0100
US

V. Phone/Fax

Practice location:
  • Phone: 423-698-1844
  • Fax:
Mailing address:
  • Phone: 423-698-1844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number48761
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number68076
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: