Healthcare Provider Details

I. General information

NPI: 1811055221
Provider Name (Legal Business Name): PETER DUNAWAY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 06/04/2021
Certification Date: 06/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2755 NEW SALEM HWY # 2A
MURFREESBORO TN
37128-5253
US

IV. Provider business mailing address

300 20TH AVE N STE 403
NASHVILLE TN
37203-5180
US

V. Phone/Fax

Practice location:
  • Phone: 629-218-6780
  • Fax:
Mailing address:
  • Phone: 615-284-7224
  • Fax: 615-806-6714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License NumberMD0000030700
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number30700
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: