Individual
MARC MICKIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6746 CHARLOTTE PIKE, NASHVILLE, TN 37209
(615) 647-9005
Mailing address
4608 INDIANA AVE, NASHVILLE, TN 37209-2328
(615) 604-8364
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD37402
TN
Other
Enumeration date
10/09/2006
Last updated
08/09/2018
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