Provider Demographics
NPI:1447268024
Name:WASUDEV, PRAMOD B (MD)
Entity type:Individual
Prefix:DR
First Name:PRAMOD
Middle Name:B
Last Name:WASUDEV
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:3443 DICKERSON PIKE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-2519
Mailing Address - Country:US
Mailing Address - Phone:615-865-0700
Mailing Address - Fax:615-865-8838
Practice Address - Street 1:3443 DICKERSON PIKE
Practice Address - Street 2:SUITE 600
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-2519
Practice Address - Country:US
Practice Address - Phone:615-865-0700
Practice Address - Fax:615-865-8838
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN011442202C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical Examiner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TND32061Medicare UPIN
TN3170870Medicare ID - Type Unspecified