Individual
SAMUEL R BASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2339 HILLSBORO RD, SUITE 100, FRANKLIN, TN 37069-6225
(615) 224-1970
(615) 916-3946
Mailing address
222 22ND AVE N, SUITE 100, NASHVILLE, TN 37203-1852
(615) 284-2222
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD21179
TN
208000000X
Pediatrics Physician
MD21179
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1504970
—
TN
Enumeration date
11/02/2005
Last updated
01/27/2016
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