Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 021581 | TN |
N | 111NI0900X | Internist | 021581 | TN |
N | 207RC0200X | Critical Care Medicine | 021581 | TN |
Y | 207RP1001X | Pulmonary Disease | 21581 | TN |
N | 2080P0214X | Pediatric Pulmonologist | 021581 | TN |
NPI | 1386686137 |
---|---|
Provider Name | Mark T. Peters |
First Address | Nashville, TN 37205-2245 |
Second Address | Nashville, TN 37205-2013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 07/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10077103 | AMERIGROUP-TNCARE AND MCR ADVANTAGE (01) | TN |
1100342185 | USA PPO-GEHA (01) | TN |
12255039 | MULTIPLAN/PHCS (01) | TN |
1508914 | (05) | TN |
164099509 | UNITED HEALTHCARE (01) | TN |
2092886 | CIGNA (01) | TN |
290013797 | MEDICARE RR (01) | TN |
4018883 | BLUE CROSS OF TN (01) | TN |
5557149 | AETNA (01) | TN |
64920762 | (05) | KY |
849925 | USA-MCO (01) | TN |
TN0190 | AMERICHOICE-TENNCARE ONLY (01) | TN |