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NPI Code Detail

MEDICARE: MR. ANGEL D ACEVEDO MD

MEDICARE: MR. ANGEL D ACEVEDO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician42395TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174506968
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANGEL D ACEVEDO MD
Provider Business Mailing Address
First Line : PO BOX 15004
Second Line :
City : KNOXVILLE
State : TN
Zip : 37901-5004
Country : US
Telephone Number : 865-541-8895
Fax Number : 865-633-4808
Provider Business Practice Location Address
First Line : 1400 DUTCH VALLEY DRIVE
Second Line :
City : KNOXVILLE
State : TN
Zip : 37918-1424
Country : US
Telephone Number : 865-689-1122
Fax Number : 866-340-3781
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2005
Last Update Date : 08/15/2024

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