Provider Demographics
NPI:1801831987
Name:MCHARGUE, DONNA D (MD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:D
Last Name:MCHARGUE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10810 PARKSIDE DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-1979
Mailing Address - Country:US
Mailing Address - Phone:865-218-6677
Mailing Address - Fax:865-218-6678
Practice Address - Street 1:10810 PARKSIDE DR
Practice Address - Street 2:SUITE 103
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1979
Practice Address - Country:US
Practice Address - Phone:865-218-6677
Practice Address - Fax:865-218-6678
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20540207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3053532Medicaid
TN110122357OtherRR MEDICARE PIN
TN3721615Medicare ID - Type UnspecifiedLEGACY GROUP
E27977Medicare UPIN
TN110122357OtherRR MEDICARE PIN