Provider Demographics
NPI:1851367866
Name:PARAWAN, W CRISTINA SEVILLA (MD)
Entity Type:Individual
Prefix:
First Name:W CRISTINA
Middle Name:SEVILLA
Last Name:PARAWAN
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 1:200 DOVER ST
Mailing Address - Street 2:STE 108
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-2790
Mailing Address - Country:US
Mailing Address - Phone:931-680-4990
Mailing Address - Fax:931-680-4970
Practice Address - Street 1:200 DOVER ST
Practice Address - Street 2:STE 108
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-2790
Practice Address - Country:US
Practice Address - Phone:931-680-4990
Practice Address - Fax:931-680-4970
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36597207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
4045060OtherBCBS
H16834Medicare UPIN
TN3876021Medicare ID - Type Unspecified