Healthcare Provider Details

I. General information

NPI: 1679217434
Provider Name (Legal Business Name): BUSRA GUNGOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2022
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2011 MURPHY AVE STE 200
NASHVILLE TN
37203-2047
US

IV. Provider business mailing address

300 20TH AVE N STE 403
NASHVILLE TN
37203-5180
US

V. Phone/Fax

Practice location:
  • Phone: 615-301-1000
  • Fax: 615-301-2329
Mailing address:
  • Phone: 615-284-4088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number247639
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: