Basic Information
| Provider Information | |||||||||
| NPI: | 1891748653 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SUD | ||||||||
| FirstName: | AVINASH | ||||||||
| MiddleName: | MOHINDER | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 210 25TH AVE N STE 1204 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372031620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153120600 | ||||||||
| FaxNumber: | 6153203259 | ||||||||
| Practice Location | |||||||||
| Address1: | 210 25TH AVE N STE 1204 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372031620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153120600 | ||||||||
| FaxNumber: | 6153203259 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2006 | ||||||||
| LastUpdateDate: | 03/09/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085N0700X | MD0000032234 | TN | N | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | 2085N0904X | MD0000032234 | TN | N | Allopathic & Osteopathic Physicians | Radiology | Nuclear Radiology | 2085R0204X | MD0000032234 | TN | N | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | 2085U0001X | MD0000032234 | TN | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Ultrasound | 2085R0202X | 32234 | TN | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 207UN0902X | MD0000032234 | TN | N | Allopathic & Osteopathic Physicians | Nuclear Medicine | Nuclear Imaging & Therapy |
ID Information
| ID | Type | State | Issuer | Description | 000867248V | 05 | GA | MEDICAID | 3848175 | 05 | TN | MEDICAID |