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General NPI Number Information
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NPI Number | 1871709170
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Entity Type | Individual
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Provider Name | ANJANI DHAMODHARAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 09/10/2018
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Provider Practice Location Address
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Address Line | 1310 24TH AVE S
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City | NASHVILLE
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State | TN
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Zip | 37212-2637
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Country | US
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Telephone | 615-873-7793
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Fax |
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Provider Business Mailing Address
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Address Line | 707 HELMSDALE PL S
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City | BRENTWOOD
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State | TN
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Zip | 37027-5520
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Country | US
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Telephone | 615-293-8971
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MT183544
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD430291
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD0000050545
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License Number State | TN
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