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Individual

SHEILA DENEEN PERTILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1559 SPARTA ST, MC MINNVILLE, TN 37110-1316
(931) 815-4212
(931) 815-4718
Mailing address
1559 SPARTA ST, MC MINNVILLE, TN 37110-1316
(931) 815-4212
(931) 815-4718

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
037210
TN
208M00000X
Hospitalist Physician
37210
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
037210
MD LICENSE
TN
Enumeration date
06/15/2006
Last updated
10/15/2012
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