Provider Demographics
NPI:1649278474
Name:MERTZ, HOWARD R (MD)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:R
Last Name:MERTZ
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 1:104 WOODMONT BLVD
Mailing Address - Street 2:SUITE LL50
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2245
Mailing Address - Country:US
Mailing Address - Phone:615-386-2361
Mailing Address - Fax:615-386-2399
Practice Address - Street 1:4230 HARDING ROAD
Practice Address - Street 2:SUITE 309 MEDICAL PLAZA WEST
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-383-0165
Practice Address - Fax:615-292-4657
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD0000025618207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00051146OtherRAILROAD MEDICARE PIN
TNQ011232Medicaid
TN3384297Medicaid
TNP00051146OtherRAILROAD MEDICARE PIN
E93648Medicare UPIN
TN3084605Medicare PIN