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NPI Code Detail

MEDICARE: NARA GRANJA INGRAM

MEDICARE:   NARA  GRANJA INGRAM
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
12084P0800XPsychiatry Physician51328TN

General Provider Information

NPI Number : 1336465251
Entity Type Code : Individual
Provider Name (Legal Business Name) : NARA GRANJA INGRAM
Provider Business Mailing Address
First Line : 1601 23RD AVE SOUTH
Second Line : SUITE 3057
City : NASHVILLE
State : TN
Zip : 37212-3139
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1601 23RD AVE SOUTH
Second Line : SUITE 3057
City : NASHVILLE
State : TN
Zip : 37212-3139
Country : US
Telephone Number : 615-327-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2010
Last Update Date : 08/05/2014

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Directions to “ NARA GRANJA INGRAM ” Practice Location

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