Individual
MICHAEL R NANNENGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
105 W STONE DR, STE 5D, KINGSPORT, TN 37660-3365
(423) 857-2790
(423) 857-2791
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2066
(423) 857-2070
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD46522
TN
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MD46522
TN
Other
Enumeration date
09/16/2006
Last updated
07/18/2011
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