Provider Demographics
NPI:1982666442
Name:ALDERMAN, DANIEL F (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:F
Last Name:ALDERMAN
Suffix:
Gender:M
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:PO BOX 11167
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37939-1167
Mailing Address - Country:US
Mailing Address - Phone:865-584-7376
Mailing Address - Fax:865-540-3856
Practice Address - Street 1:2240 SUTHERLAND AVE
Practice Address - Street 2:STE 107
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-2333
Practice Address - Country:US
Practice Address - Phone:406-587-8631
Practice Address - Fax:406-587-1343
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT97712085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0073712Medicaid
TNQ030566Medicaid
MT0144729Medicaid
MT0144729Medicaid
000084003Medicare PIN
000084791Medicare PIN
MT84003Medicare ID - Type UnspecifiedADVANCED MEDICAL IMAGING