Provider Demographics
NPI:1346217999
Name:DARVILLE, MICHAEL NITARI (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:NITARI
Last Name:DARVILLE
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 1:304 CAMILLE COURT
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013
Mailing Address - Country:US
Mailing Address - Phone:615-429-2903
Mailing Address - Fax:615-837-4514
Practice Address - Street 1:1412 COUNTY HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37218
Practice Address - Country:US
Practice Address - Phone:615-364-4158
Practice Address - Fax:615-837-4514
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39795207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3332698Medicaid
TN3332698Medicaid
I38030Medicare UPIN