Individual
MARK PELEROSSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
110 29TH AVE N, STE 202, NASHVILLE, TN 37203-1401
(615) 327-4304
Mailing address
110 29TH AVE N, STE 202, NASHVILLE, TN 37203-1401
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
022096
TN
207L00000X
Anesthesiology Physician
Primary
22096
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009901215
—
AL
01
—
3018648
BCBS PROVIDER NUMBER
TN
05
—
3067066
—
TN
05
—
64911654
—
KY
Enumeration date
06/30/2005
Last updated
08/20/2008
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