Organization
COMPLETE FAMILY CARE OF MARYVILLE, PLLC
Active
Organization
COMPLETE FAMILY CARE OF MARYVILLE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW O. SUGANTHARAIS MD (MEDICAL DIRECTOR)
(865) 982-4301
Entity
Organization
Contact information
Practice address
2004 E. BROADWAY, MARYVILLE, TN 37804
(865) 982-4301
Mailing address
2004 E. BROADWAY, MARYVILLE, TN 37804
(865) 982-4301
(865) 357-8869
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25789
TN
Other
Enumeration date
09/21/2010
Last updated
09/21/2010
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