Healthcare Provider Details

I. General information

NPI: 1114455326
Provider Name (Legal Business Name): NASHVILLE HEART AND VASCULAR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2017
Last Update Date: 06/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

397 WALLACE RD STE C216
NASHVILLE TN
37211-8019
US

IV. Provider business mailing address

6525 BROWNLEE DR
NASHVILLE TN
37205-3051
US

V. Phone/Fax

Practice location:
  • Phone: 615-832-8731
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number45269
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number45269
License Number StateTN

VIII. Authorized Official

Name: EITAN FRIEDMAN
Title or Position: PHYSICIAN
Credential: MD
Phone: 617-838-8826