Organization
EAST TENNESSEE VASCULAR CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAHIN ASSADNIA M.D. (PHYSICIAN/OWNER)
(423) 317-6560
Entity
Organization
Contact information
Practice address
1125 W 1ST NORTH ST, STE. B, MORRISTOWN, TN 37814-4562
(423) 317-6560
(423) 317-6570
Mailing address
PO BOX 1855, MORRISTOWN, TN 37816-1855
(423) 317-6560
(423) 317-6570
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
MD35881
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114909538
INDIVIDUAL NPI
TN
01
—
1639178932
INDIVIDUAL NPI
TN
05
—
3723200
—
TN
01
—
4075540
BLUE CROSS BLUE SHIELD
TN
01
—
P00122001
RAILROAD MEDICARE
TN
Enumeration date
08/15/2006
Last updated
09/29/2011
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