Provider Demographics
NPI:1508021718
Name:KIRAN, UNNATI M (MD)
Entity Type:Individual
Prefix:
First Name:UNNATI
Middle Name:M
Last Name:KIRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:UNNATI
Other - Middle Name:
Other - Last Name:MEHTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 3889
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37602-3889
Mailing Address - Country:US
Mailing Address - Phone:423-794-5738
Mailing Address - Fax:423-283-9480
Practice Address - Street 1:301 MED TECH PKWY
Practice Address - Street 2:SUITE 240
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-2364
Practice Address - Country:US
Practice Address - Phone:423-794-5520
Practice Address - Fax:423-282-0720
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT52242207R00000X, 208M00000X
TN46418207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1520658Medicaid
TN103I117551Medicare PIN
TNP00865701Medicare PIN