Healthcare Provider Details
I. General information
NPI: 1235040106
Provider Name (Legal Business Name): MVC TN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2410 PATTERSON ST STE 23STO
NASHVILLE TN
37203-1551
US
IV. Provider business mailing address
7125 ORCHARD LAKE RD STE 120
WEST BLOOMFIELD MI
48322-3627
US
V. Phone/Fax
- Phone: 248-847-4924
- Fax: 248-479-1900
- Phone: 248-847-4924
- Fax: 248-479-1900
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
PHIL
LOPRESTI
Title or Position: PHYSICIAN
Credential: DO
Phone: 248-847-4924