Healthcare Provider Details

I. General information

NPI: 1598694606
Provider Name (Legal Business Name): LEELA PRIYADHARSHANI DURAIMURUGAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

975 EAST THIRD STREET, HOSPITAL BOX 112
CHATTANOOGA TN
37403
US

IV. Provider business mailing address

975 EAST THIRD STREET, HOSPITAL BOX 112
CHATTANOOGA TN
37403
US

V. Phone/Fax

Practice location:
  • Phone: 423-778-8179
  • Fax: 423-778-8180
Mailing address:
  • Phone: 423-778-8179
  • Fax: 423-778-8180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: