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NPI Code Detail

MEDICARE: DANA R BANNERMAN MD

MEDICARE: DANA R BANNERMAN 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
1208M00000XHospitalist Physician34669TN
2207R00000XInternal Medicine Physician34669TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24171393OTHERTNBLUE CROSS BLUE SHIELD
37082394OTHERTNAETNA

General Provider Information

NPI Number : 1649274515
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANA R BANNERMAN MD
Provider Business Mailing Address
First Line : PO BOX 501123
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63150-0001
Country : US
Telephone Number : 615-284-4672
Fax Number : 615-284-5752
Provider Business Practice Location Address
First Line : 2010 CHURCH ST
Second Line : STE 310
City : NASHVILLE
State : TN
Zip : 37203-2012
Country : US
Telephone Number : 615-284-4672
Fax Number : 615-284-5752
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 03/17/2025

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Directions to “ DANA R BANNERMAN MD” Practice Location

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