Basic Information
| Provider Information | |||||||||
| NPI: | 1649358581 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BASTARACHE | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | ANNE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1310 24TH AVE S | ||||||||
| Address2: | MEDICAL SERVICE, PULMONARY | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372122637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153274751 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1310 24TH AVE S | ||||||||
| Address2: | MEDICAL SERVICE, PULMONARY | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372122637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153274751 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 36178 | TN | X | Allopathic & Osteopathic Physicians | Internal Medicine | 207RP1001X | 36178 | TN | X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.