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Individual

MICHAEL DONOHUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
100 W 4TH ST, SUITE 310, COOKEVILLE, TN 38501-2448
(931) 528-7877
(931) 526-3261
Mailing address
100 W 4TH ST, SUITE 310, COOKEVILLE, TN 38501-2448
(931) 528-7877
(931) 526-3261

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
73492
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
9398
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3628683
TN
01
4083390
BCBS
TN
05
74011982
KY
01
P00183596
MEDICARE RAILROAD
TN
Enumeration date
10/11/2005
Last updated
12/16/2013
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