Provider Demographics
NPI:1265847040
Name:SAUVAGEAU, MITCHEL (DO)
Entity Type:Individual
Prefix:DR
First Name:MITCHEL
Middle Name:
Last Name:SAUVAGEAU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 WOODMONT BLVD STE LL50
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2382
Mailing Address - Country:US
Mailing Address - Phone:402-499-6252
Mailing Address - Fax:
Practice Address - Street 1:4230 HARDING PIKE STE 400
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-4900
Practice Address - Country:US
Practice Address - Phone:615-386-9089
Practice Address - Fax:615-386-2399
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101021207207YS0123X
TN3681207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery