Provider Demographics
NPI:1093747651
Name:CHIN, PETER ANTHONY
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:ANTHONY
Last Name:CHIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 21ST AVE S STE 701
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-2700
Mailing Address - Country:US
Mailing Address - Phone:615-936-1595
Mailing Address - Fax:
Practice Address - Street 1:2200 CHILDRENS WAY STE 3115
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0005
Practice Address - Country:US
Practice Address - Phone:615-936-0023
Practice Address - Fax:615-936-4294
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75219207L00000X
TXM3992207LP3000X
TN42993207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2621100-00Medicaid
TX8L10178Medicare PIN
FL2621100-00Medicaid
FL03156Medicare ID - Type Unspecified