Individual
MR. GERARD K MAZZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2725 KEITH ST NW, CLEVELAND, TN 37312
(423) 476-3330
(423) 476-5802
Mailing address
2725 KEITH ST NW, CLEVELAND, TN 37312
(423) 476-3330
(423) 476-5802
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD015727
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3841466
—
TN
01
—
4009361
BCBS
TN
Enumeration date
02/13/2007
Last updated
10/01/2024
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