Individual
DR. KAYVON MODJARRAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
VANDERBILT UNIVERSITY SCHOOL OF MEDICINE, A2200 MCN, 1161 21ST AVENUE SOUTH, NASHVILLE, TN 37232-0001
(615) 322-8972
Mailing address
VANDERBILT UNIVERSITY SCHOOL OF MEDICINE, A2200 MCN, 1161 21ST AVENUE SOUTH, NASHVILLE, TN 37232-0001
(615) 322-8972
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/23/2007
Last updated
07/25/2011
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