Healthcare Provider Details

I. General information

NPI: 1083818967
Provider Name (Legal Business Name): SANDEEP DUGGAL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 03/07/2023
Certification Date: 05/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 PATTERSON ST STE 502
NASHVILLE TN
37203-6511
US

IV. Provider business mailing address

2400 PATTERSON ST STE 502
NASHVILLE TN
37203-6511
US

V. Phone/Fax

Practice location:
  • Phone: 615-515-1900
  • Fax:
Mailing address:
  • Phone: 615-515-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberTP907
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number3631
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberTP907
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number03761
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: