Organization
THE PELVIC PAIN AND RECONSTRUCTIVE SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALFREDO NIEVES M.D. (MEDICAL DIRECTOR)
(423) 490-1136
Entity
Organization
Contact information
Practice address
1755 GUNBARREL RD, SUITE 202, CHATTANOOGA, TN 37421-7137
(423) 490-1136
Mailing address
1755 GUNBARREL RD, SUITE 202, CHATTANOOGA, TN 37421-7137
(423) 490-1136
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
024075
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3735545
MEDICARE PIN
TN
01
—
4133945
BCBS
TN
Enumeration date
11/16/2006
Last updated
01/10/2008
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