Provider Demographics
NPI:1912968033
Name:EMANUEL, PETER G (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:G
Last Name:EMANUEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 LAUREL AVE # N304
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37916-1810
Mailing Address - Country:US
Mailing Address - Phone:865-595-4100
Mailing Address - Fax:865-525-6811
Practice Address - Street 1:4709 PAPERMILL DR
Practice Address - Street 2:SUITE 201
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-1921
Practice Address - Country:US
Practice Address - Phone:865-766-6870
Practice Address - Fax:865-766-0133
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN291362085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN300086478OtherRR MEDICARE
TN4023273OtherBC/BS OF TN
TN3816909Medicaid
KY64928856Medicaid
TN4023273OtherBC/BS OF TN
TN300086478OtherRR MEDICARE