Provider Demographics
NPI:1063659209
Name:CAI, SONGMIN (MD)
Entity Type:Individual
Prefix:DR
First Name:SONGMIN
Middle Name:
Last Name:CAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6556 BANBURY XING
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8262
Mailing Address - Country:US
Mailing Address - Phone:615-834-6419
Mailing Address - Fax:
Practice Address - Street 1:10 KNOLLS PL
Practice Address - Street 2:KNOLLS PLACE MEDICAL CILINC
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-7410
Practice Address - Country:US
Practice Address - Phone:615-457-1265
Practice Address - Fax:615-457-1326
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000045100208M00000X
KY42531207P00000X
TN45100146D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1504437Medicaid
TN1504437Medicaid