Individual
MARTYN J CAVALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
110 29TH AVE N, STE 202, NASHVILLE, TN 37203-1448
(615) 327-4304
(615) 327-7940
Mailing address
110 29TH AVE N, STE 202, NASHVILLE, TN 37203-1448
(615) 327-4304
(615) 327-7940
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
27196
TN
207L00000X
Anesthesiology Physician
Primary
27196
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009905170
—
AL
05
—
3097610
—
TN
01
—
3112678
BCBS PROVIDER NUMBER
TN
05
—
64924145
—
KY
Enumeration date
06/20/2005
Last updated
11/21/2014
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