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General NPI Number Information
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NPI Number | 1821619792
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Entity Type | Individual
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Provider Name | SHIVA MOHAN
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Gender | Male
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Dates
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Enumeration Date | 05/02/2020
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 1000 SAINT LUKE DR
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City | NASHVILLE
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State | TN
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Zip | 37205-3588
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Country | US
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Telephone | 423-926-2358
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Fax |
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Provider Business Mailing Address
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Address Line | 2717 E OAKLAND AVE
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City | JOHNSON CITY
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State | TN
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Zip | 37601-1843
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Country | US
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Telephone | 423-926-2358
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | PT20231
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 75474
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License Number State | TN
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