Dr Mitali Nanda, MD | |
515 Stonecrest Pkwy, Suite 150, Smyrna, TN 37167-6826 | |
(615) 223-1550 | |
(615) 223-1331 |
Full Name | Dr Mitali Nanda |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 515 Stonecrest Pkwy, Smyrna, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1215282025 | NPI | - | NPPES |
Q017916 | Medicaid | TN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | MD0000053102 (Tennessee) | Primary |
Entity Name | Permanente Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
Mailing Address | Practice Location Address |
---|---|
Dr Mitali Nanda, MD 11103 Quietgrove Rd, Smyrna, TN 37167-2984 Ph: (347) 726-1959 | Dr Mitali Nanda, MD 515 Stonecrest Pkwy, Suite 150, Smyrna, TN 37167-6826 Ph: (615) 223-1550 |
Dana J Haselton, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 699 President Pl, Smyrna, TN 37167 Phone: 615-459-5252 | |
Lee David Mockrin, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 515 Stonecrest Pkwy, Suite 150, Smyrna, TN 37167 Phone: 615-223-1350 Fax: 615-223-1351 | |
Rachel Ames, NP Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 537 Stonecrest Pkwy Ste 201, Smyrna, TN 37167 Phone: 615-625-0270 | |
Miss Rachel Morales Ricafort, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 739 President Pl Ste 110, Smyrna, TN 37167 Phone: 615-625-7780 Fax: 615-625-7781 | |
Dr. Catherine Sipe Bottoms, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 741 President Pl, Suite 210, Smyrna, TN 37167 Phone: 615-223-5565 Fax: 615-223-5509 | |
Melissa Emily Fuller, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 741 President Place, Suite 210, Smyrna, TN 37167 Phone: 615-223-5565 Fax: 615-223-5509 |