Provider Demographics
NPI:1235358938
Name:ADESHINA, TAWANDA G (MD)
Entity Type:Individual
Prefix:DR
First Name:TAWANDA
Middle Name:G
Last Name:ADESHINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TAWANDA
Other - Middle Name:G
Other - Last Name:COVEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7305 JARNIGAN ROAD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421
Mailing Address - Country:US
Mailing Address - Phone:423-495-4345
Mailing Address - Fax:423-495-4934
Practice Address - Street 1:101 KINGTON LANE
Practice Address - Street 2:
Practice Address - City:CHICKAMAUGA
Practice Address - State:GA
Practice Address - Zip Code:30707
Practice Address - Country:US
Practice Address - Phone:706-375-9400
Practice Address - Fax:706-375-9491
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA070692207Q00000X
CAA98895207Q00000X
TN57005207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine