MEDICARE: PEPITO SALCEDO 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
1	207Q00000X	Family Medicine Physician	007659	TN

General Provider Information

NPI Number	:	1588630255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEPITO SALCEDO MD

Provider Business Mailing Address
First Line	:	2 MARYLAND FARMS
Second Line	:	SUITE 222
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-5007
Country	:	US
Telephone Number	:	800-661-3365
Fax Number	:	866-689-4661

Provider Business Practice Location Address
First Line	:	103 REDBUD DR
Second Line	:	SUITE E
City	:	PORTLAND
State	:	TN
Zip	:	37148-1617
Country	:	US
Telephone Number	:	615-325-1206
Fax Number	:	615-325-1245

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	07/08/2007

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Directions to “ PEPITO SALCEDO MD” Practice Location

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