Organization
MID-STATE UROLOGY PC
Active
Other names
Mid-South Pediatric Urology PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HERBERT VICTOR BRAREN MD (PRESIDENT)
(615) 321-0481
Entity
Organization
Contact information
Practice address
329 21ST AVE N, SUITE 2, NASHVILLE, TN 37203-1839
(615) 321-0481
(615) 321-5649
Mailing address
329 21ST AVE N, SUITE 2, NASHVILLE, TN 37203-1839
(615) 321-0481
(615) 321-5649
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
2088P0231X
Pediatric Urology Physician
—
—
Other
Enumeration date
01/20/2011
Last updated
01/20/2011
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