Individual
DR. EDMUNDO DIEGO MAGPANTAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
339 WHITE BRIDGE PIKE, NASHVILLE, TN 37209-3208
(615) 356-6877
(615) 356-8270
Mailing address
339 WHITE BRIDGE PIKE, NASHVILLE, TN 37209-3208
(615) 356-6877
(615) 356-8270
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD7717
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4019336
BLUE CROSS BLUE SHIELD TN
TN
Enumeration date
09/08/2005
Last updated
12/24/2007
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