Individual
PHILIP MAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
110 29TH AVE N, STE 202, NASHVILLE, TN 37203-1401
(615) 327-4304
Mailing address
110 29TH AVE N, STE 202, NASHVILLE, TN 37203-1401
(615) 327-4304
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
047087
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3057417
BCBS NUMBER
TN
05
—
3625233
—
TN
05
—
74470873
—
KY
Enumeration date
09/20/2005
Last updated
05/17/2016
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