Healthcare Provider Details

I. General information

NPI: 1518952308
Provider Name (Legal Business Name): NASHVILLE DIGESTIVE DISEASE CENTER, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2005
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 BRIARVILLE RD
MADISON TN
37115-5127
US

IV. Provider business mailing address

1308 BRIARVILLE RD
MADISON TN
37115-5127
US

V. Phone/Fax

Practice location:
  • Phone: 615-868-3131
  • Fax: 615-868-0205
Mailing address:
  • Phone: 615-868-3131
  • Fax: 615-515-0205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MENE SUGAGE ZUA
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 615-868-3131