Basic Information
| Provider Information | |||||||||
| NPI: | 1871779124 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PRAMOD B. WASUDEV, M.D., PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 22329 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372022329 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158650700 | ||||||||
| FaxNumber: | 6158650701 | ||||||||
| Practice Location | |||||||||
| Address1: | 3443 DICKERSON PIKE | ||||||||
| Address2: | SUITE 600 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372072525 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158650700 | ||||||||
| FaxNumber: | 6158650701 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2008 | ||||||||
| LastUpdateDate: | 01/17/2008 | ||||||||
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| AuthorizedOfficialLastName: | WASUDEV | ||||||||
| AuthorizedOfficialFirstName: | PRAMOD | ||||||||
| AuthorizedOfficialMiddleName: | B. | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6158650700 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 11442 | TN | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.