MEDICARE: NARESH R MISTRY 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	207RC0000X	Cardiovascular Disease Physician	MD27232	TN

Other Identifiers

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

General Provider Information

NPI Number	:	1699763250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NARESH R MISTRY MD

Provider Business Mailing Address
First Line	:	689 MEDICAL PARK DR STE 301
Second Line	:
City	:	LENOIR CITY
State	:	TN
Zip	:	37772-5798
Country	:	US
Telephone Number	:	865-986-8121
Fax Number	:	865-986-8124

Provider Business Practice Location Address
First Line	:	689 MEDICAL PARK DR STE 301
Second Line	:
City	:	LENOIR CITY
State	:	TN
Zip	:	37772-5798
Country	:	US
Telephone Number	:	865-986-8121
Fax Number	:	865-986-8124

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

Provider Enumeration Date	:	10/07/2005
Last Update Date	:	04/17/2024

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Directions to “ NARESH R MISTRY MD” Practice Location

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