Provider Demographics
NPI:1861497570
Name:BATTIWALLA, MINOCHER MANECK (MD)
Entity Type:Individual
Prefix:
First Name:MINOCHER
Middle Name:MANECK
Last Name:BATTIWALLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MINOO
Other - Middle Name:
Other - Last Name:BATTIWALLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2410 PATTERSON ST STE 500
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-6521
Mailing Address - Country:US
Mailing Address - Phone:615-342-4912
Mailing Address - Fax:615-342-4913
Practice Address - Street 1:2410 PATTERSON ST STE 500
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203
Practice Address - Country:US
Practice Address - Phone:615-342-4912
Practice Address - Fax:615-342-4913
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-17
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002009174400000X
MDD0069707208M00000X
TN56812207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No174400000XOther Service ProvidersSpecialist
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02461058Medicaid
NYH98836Medicare UPIN