Provider Demographics
NPI:1861475188
Name:VAFAI, PARVIN (MD)
Entity Type:Individual
Prefix:MRS
First Name:PARVIN
Middle Name:
Last Name:VAFAI
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 1:3786 CENTRAL PIKE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-3497
Mailing Address - Country:US
Mailing Address - Phone:615-883-2200
Mailing Address - Fax:615-883-1104
Practice Address - Street 1:3786 CENTRAL PIKE
Practice Address - Street 2:SUITE 130
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-3497
Practice Address - Country:US
Practice Address - Phone:615-883-2200
Practice Address - Fax:615-883-1104
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN023719208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3005008Medicaid
TN3005008Medicaid