Provider Demographics
NPI:1356390579
Name:TODD, NIVIN CHRISTIE (MD)
Entity type:Individual
Prefix:DR
First Name:NIVIN
Middle Name:CHRISTIE
Last Name:TODD
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 1:1755 GUNBARREL RD STE 205
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3185
Mailing Address - Country:US
Mailing Address - Phone:423-777-4579
Mailing Address - Fax:423-777-4580
Practice Address - Street 1:1755 GUNBARREL RD
Practice Address - Street 2:SUITE 205
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-7137
Practice Address - Country:US
Practice Address - Phone:423-777-4579
Practice Address - Fax:423-777-4580
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30838174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4013078OtherBLUE CROSS BLUE SHIELD
TN30838OtherMEDICAL LICENSE
TN30838OtherMEDICAL LICENSE
TNBS6009319OtherDEA