Healthcare Provider Details

I. General information

NPI: 1861475188
Provider Name (Legal Business Name): PARVIN VAFAI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 06/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3786 CENTRAL PIKE SUITE 130
HERMITAGE TN
37076-3497
US

IV. Provider business mailing address

3786 CENTRAL PIKE SUITE 130
HERMITAGE TN
37076-3497
US

V. Phone/Fax

Practice location:
  • Phone: 615-883-2200
  • Fax: 615-883-1104
Mailing address:
  • Phone: 615-883-2200
  • Fax: 615-883-1104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number023719
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: