Healthcare Provider Details

I. General information

NPI: 1871797019
Provider Name (Legal Business Name): PAUL MICHAEL PASARILLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 06/26/2020
Certification Date: 06/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1272 GARRISON DR
MURFREESBORO TN
37129-2570
US

IV. Provider business mailing address

1272 GARRISON DR
MURFREESBORO TN
37129-2570
US

V. Phone/Fax

Practice location:
  • Phone: 615-867-8040
  • Fax:
Mailing address:
  • Phone: 615-867-8040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD43217
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMT-182974
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: