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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