Individual
MARK KOENIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4230 HARDING RD, SUITE 330, NASHVILLE, TN 37205
(615) 259-4545
(615) 565-6789
Mailing address
300 20TH AVE N STE 403, NASHVILLE, TN 37203-5180
(615) 284-7260
(615) 284-7501
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
32261
TN
207RI0011X
Interventional Cardiology Physician
Primary
32261
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3330967
—
TN
01
—
6012068
BLUE CROSS-BLUE SHIELD
TN
01
—
P01376525
RR MEDICARE
TN
Enumeration date
06/03/2006
Last updated
08/02/2021
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