Provider Demographics
NPI:1063449031
Name:MALTZ, BRAD E (MD)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:E
Last Name:MALTZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3841 GREEN HILLS VILLAGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2691
Mailing Address - Country:US
Mailing Address - Phone:615-936-2000
Mailing Address - Fax:615-343-8174
Practice Address - Street 1:VANDERBILT MEDICAL CTR
Practice Address - Street 2:1660 THE VANDERBILT CLINIC
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0001
Practice Address - Country:US
Practice Address - Phone:615-322-0128
Practice Address - Fax:615-343-8174
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD39523207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
620476822OtherTAX ID