Individual
PRAMOD K CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5301 VIRGINIA WAY, 300, BRENTWOOD, TN 37027-7541
(615) 221-4474
(615) 234-3774
Mailing address
5301 VIRGINIA WAY, 300, BRENTWOOD, TN 37027-7541
(615) 221-4474
(615) 234-3774
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
1057709
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000487824
ANTHEM BC/BS
IN
01
—
000000587715
ANTHEM BC/BS
IN
05
—
200523440
—
IN
05
—
2673647
—
OH
01
—
P00704761
RAILROAD MEDICARE
IN
Enumeration date
06/17/2006
Last updated
01/09/2012
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