Individual
ANGELO E. CANONICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3601 THE VANDERBILT CLINIC, NASHVILLE, TN 37232-0001
(615) 322-5000
Mailing address
3841 GREEN HILLS VILLAGE DR STE 200, NASHVILLE, TN 37215-2691
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
019712
TN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
19712
TN
207RP1001X
Pulmonary Disease Physician
19712
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12079668
MULTIPLAN/PHCS
TN
05
—
1510158
—
TN
05
—
1510392
—
TN
01
—
258288
USA MCO
TN
01
—
290013543
MEDICARE RR
TN
01
—
3164295
BLUE CROSS OF TN
TN
01
—
5541480
CIGNA
TN
05
—
64916679
—
KY
01
—
982568
UNITED HEALTHCARE
TN
Enumeration date
06/07/2006
Last updated
09/10/2025
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