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General NPI Number Information
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NPI Number | 1619088960
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Entity Type | Organization
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Legal Business Name | SOMAYAJI GASTROENTEROLOGY GROUP, PC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2010 CHURCH ST SUITE 508
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City | NASHVILLE
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State | TN
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Zip | 37203-2012
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Country | US
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Telephone | 615-329-7820
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Fax |
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Provider Business Mailing Address
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Address Line | 2010 CHURCH ST SUITE 508
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City | NASHVILLE
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State | TN
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Zip | 37203-2012
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Country | US
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Telephone | 615-329-7820
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BUNTWAL N SOMAYAJI
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Credential | M.D.
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Telephone | 615-329-7820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD007279
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License Number State | TN
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