Provider Demographics
NPI:1376800979
Name:PIETRANGELO, JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:PIETRANGELO
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 1:8000 WOLF RIVER BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1756
Mailing Address - Country:US
Mailing Address - Phone:901-579-7395
Mailing Address - Fax:901-425-9813
Practice Address - Street 1:8000 WOLF RIVER BLVD STE 100
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1756
Practice Address - Country:US
Practice Address - Phone:901-579-7395
Practice Address - Fax:901-425-9813
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN54195207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology