Healthcare Provider Details

I. General information

NPI: 1306997804
Provider Name (Legal Business Name): JONATHAN CUDA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2007
Last Update Date: 08/20/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4220 HARDING PIKE
NASHVILLE TN
37205-2005
US

IV. Provider business mailing address

4220 HARDING PIKE
NASHVILLE TN
37205-2005
US

V. Phone/Fax

Practice location:
  • Phone: 615-298-4100
  • Fax:
Mailing address:
  • Phone: 615-298-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number68529
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number68529
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: