Provider Demographics
NPI:1083024038
Name:ARYEETEY, PRINCE MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:PRINCE
Middle Name:MICHAEL
Last Name:ARYEETEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:251 N LYERLY ST
Mailing Address - Street 2:STE 100
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-2743
Mailing Address - Country:US
Mailing Address - Phone:423-826-8000
Mailing Address - Fax:
Practice Address - Street 1:251 N LYERLY ST
Practice Address - Street 2:STE 100
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-2743
Practice Address - Country:US
Practice Address - Phone:423-826-8000
Practice Address - Fax:423-702-7917
Is Sole Proprietor?:No
Enumeration Date:2014-04-30
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN56466207RN0300X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ032504Medicaid