Provider Demographics
NPI:1932183779
Name:PRIEST, EDWARD M II (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:M
Last Name:PRIEST
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:210 25TH AVENUE NORTH
Mailing Address - Street 2:SUITE 602
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203
Mailing Address - Country:US
Mailing Address - Phone:615-312-0600
Mailing Address - Fax:615-320-3259
Practice Address - Street 1:2300 PATTERSON STREET
Practice Address - Street 2:CENTENNIAL MEDICAL CENTER
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203
Practice Address - Country:US
Practice Address - Phone:615-342-1071
Practice Address - Fax:615-342-1065
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN88172085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3721492Medicaid
TN3718587Medicaid
TN3037513Medicaid
TN386791Medicaid
TN3721492Medicare ID - Type Unspecified
B59066Medicare UPIN
TN3868791Medicare ID - Type Unspecified
TN3791307Medicare ID - Type UnspecifiedSMRI
TN386791Medicaid
TN3718587Medicaid
TN3721492Medicaid