Healthcare Provider Details

I. General information

NPI: 1447268024
Provider Name (Legal Business Name): PRAMOD B. WASUDEV M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3443 DICKERSON PIKE SUITE 600
NASHVILLE TN
37207-2519
US

IV. Provider business mailing address

3443 DICKERSON PIKE SUITE 600
NASHVILLE TN
37207-2519
US

V. Phone/Fax

Practice location:
  • Phone: 615-865-0700
  • Fax: 615-865-8838
Mailing address:
  • Phone: 615-865-0700
  • Fax: 615-865-8838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number011442
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: