Healthcare Provider Details

I. General information

NPI: 1477182749
Provider Name (Legal Business Name): SEAN PATRICK BLIVEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2020
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1032 MCCALLIE AVE STE 200
CHATTANOOGA TN
37403-2836
US

IV. Provider business mailing address

2004 HAYES ST STE 800
NASHVILLE TN
37203-2659
US

V. Phone/Fax

Practice location:
  • Phone: 423-752-5004
  • Fax: 423-414-3834
Mailing address:
  • Phone: 615-329-5070
  • Fax: 615-329-5079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number76140
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number76140
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: