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Individual

MARK T. PETERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4230 HARDING PIKE, SUITE 400, NASHVILLE, TN 37205-2013
(615) 297-2700
(615) 386-2399
Mailing address
104 WOODMONT BLVD, SUITE 400, NASHVILLE, TN 37205-2245
(615) 386-2300
(615) 386-2399

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
021581
TN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
021581
TN
207RP1001X
Pulmonary Disease Physician
Primary
21581
TN
2080P0214X
Pediatric Pulmonology Physician
021581
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10077103
AMERIGROUP-TNCARE AND MCR ADVANTAGE
TN
01
1100342185
USA PPO-GEHA
TN
01
12255039
MULTIPLAN/PHCS
TN
05
1508914
TN
01
164099509
UNITED HEALTHCARE
TN
01
2092886
CIGNA
TN
01
290013797
MEDICARE RR
TN
01
4018883
BLUE CROSS OF TN
TN
01
5557149
AETNA
TN
05
64920762
KY
01
849925
USA-MCO
TN
01
TN0190
AMERICHOICE-TENNCARE ONLY
TN
Enumeration date
06/12/2006
Last updated
05/07/2015
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