Provider Demographics
NPI:1396919056
Name:WANNA, GEORGE (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:WANNA
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7209 MEDICAL CENTER EAST SOUTH TOWER
Mailing Address - Street 2:1215 21ST AVENUE SOUTH
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-0001
Mailing Address - Country:US
Mailing Address - Phone:917-340-5060
Mailing Address - Fax:615-343-9556
Practice Address - Street 1:7209 MEDICAL CENTER EAST SOUTH TOWER
Practice Address - Street 2:1215 21ST AVENUE SOUTH
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0001
Practice Address - Country:US
Practice Address - Phone:917-340-5060
Practice Address - Fax:615-343-9556
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYP52860207YX0901X
TNMD45898207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology