Provider Demographics
NPI:1609844778
Name:PERALES, MARIA I (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:I
Last Name:PERALES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:I
Other - Last Name:PERALES-RIVERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:397 WALLACE RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211
Mailing Address - Country:US
Mailing Address - Phone:615-331-4263
Mailing Address - Fax:615-331-3920
Practice Address - Street 1:397 WALLACE RD
Practice Address - Street 2:SUITE 204
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211
Practice Address - Country:US
Practice Address - Phone:615-331-4263
Practice Address - Fax:615-331-3920
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD14036207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3006272Medicaid
3006272Medicare ID - Type Unspecified
TN3006272Medicaid