Healthcare Provider Details

I. General information

NPI: 1518077718
Provider Name (Legal Business Name): SUMAN CHAUDHURI D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 01/15/2020
Certification Date: 01/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2933B BERRY HILL DR
NASHVILLE TN
37204-3126
US

IV. Provider business mailing address

2933B BERRY HILL DR
NASHVILLE TN
37204-3126
US

V. Phone/Fax

Practice location:
  • Phone: 615-500-4679
  • Fax: 615-500-4679
Mailing address:
  • Phone: 615-500-4679
  • Fax: 615-500-4679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number1573
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: