Provider Demographics
NPI:1104266618
Name:BELTRAN MELGAREJO, DIEGO ANDRES (MD)
Entity type:Individual
Prefix:
First Name:DIEGO
Middle Name:ANDRES
Last Name:BELTRAN MELGAREJO
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 1:1161 21ST AVE S
Mailing Address - Street 2:MEDICAL CENTER NORTH S-3223
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-0011
Mailing Address - Country:US
Mailing Address - Phone:615-343-6105
Mailing Address - Fax:
Practice Address - Street 1:1161 21ST AVE S
Practice Address - Street 2:MEDICAL CENTER NORTH S-3223
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0011
Practice Address - Country:US
Practice Address - Phone:615-343-6105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN390200000X
TXBP10047724390200000X
ND15479207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program