Healthcare Provider Details

I. General information

NPI: 1316614837
Provider Name (Legal Business Name): BRETT MICHAEL MONTELARO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2021
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 21ST AVE S
NASHVILLE TN
37232-0014
US

IV. Provider business mailing address

GRADUATE MEDICAL EDUCATION 303 LIGHT HALL
NASHVILLE TN
37232-5283
US

V. Phone/Fax

Practice location:
  • Phone: 615-322-2318
  • Fax:
Mailing address:
  • Phone: 615-322-4916
  • Fax: 615-343-1496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number99898
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: