| Cmsmc | |
|
1394 Hatcher Ln Same Columbia TN 38401-3586 | |
| (931) 388-9388 | |
| (931) 388-9808 |
| Full Name | Cmsmc |
|---|---|
| Speciality | Family Medicine |
| Location | 1394 Hatcher Ln, Columbia, Tennessee |
| Authorized Official Name and Position | Indu Bali (CEO) |
| Authorized Official Contact | 9313889388 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cmsmc 1394 Hatcher Ln Suite A Columbia TN 38401-3586 Ph: (931) 388-9388 | Cmsmc 1394 Hatcher Ln Same Columbia TN 38401-3586 Ph: (931) 388-9388 |
| NPI Number | 1497822548 |
|---|---|
| Provider Enumeration Date | 11/30/2006 |
| Last Update Date | 03/07/2023 |
| Medicare PECOS PAC ID | 9032386115 |
|---|---|
| Medicare Enrollment ID | O20120112000222 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497822548 | NPI | - | NPPES |
| 4059771 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | TN LIC # 31656 (Tennessee) | Primary |
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Secondary |
| Provider Name | Indu Bali |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1154425361 PECOS PAC ID: 3971778135 Enrollment ID: I20111216000285 |
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