Provider Demographics
NPI:1417179805
Name:ANELLO TOM, MARGARET ROSE (DO)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:ROSE
Last Name:ANELLO TOM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:ROSE
Other - Last Name:ANELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1135 CULLY RD
Mailing Address - Street 2:SUITE #100
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-8503
Mailing Address - Country:US
Mailing Address - Phone:901-752-1980
Mailing Address - Fax:
Practice Address - Street 1:1135 CULLY RD
Practice Address - Street 2:SUITE #100
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-8503
Practice Address - Country:US
Practice Address - Phone:901-752-1980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO00000022452084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry