Individual
FABIEN MALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3601 TVC, NASHVILLE, TN 37232-0001
(615) 322-3000
Mailing address
3841 GREEN HILLS VILLAGE DR STE 200, NASHVILLE, TN 37215-2691
(615) 936-2000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD52625
TN
207RP1001X
Pulmonary Disease Physician
102614
MN
207RP1001X
Pulmonary Disease Physician
48957
MN
207RP1001X
Pulmonary Disease Physician
Primary
MD52625
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34757300
—
WI
05
—
400995100
—
MN
05
—
ENROLLED
—
IA
01
—
P00759943
MEDICARE RAILROAD
MN
Enumeration date
08/12/2006
Last updated
10/30/2023
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