Provider Demographics
NPI:1194895193
Name:MUDUMBI, SARAN V (MD)
Entity type:Individual
Prefix:DR
First Name:SARAN
Middle Name:V
Last Name:MUDUMBI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2900 FELICIA ST STE 103
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-4043
Mailing Address - Country:US
Mailing Address - Phone:615-320-1395
Mailing Address - Fax:615-320-1396
Practice Address - Street 1:2900 FELICIA ST STE 103
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-4043
Practice Address - Country:US
Practice Address - Phone:615-320-1395
Practice Address - Fax:615-320-1396
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD00000311102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3846039Medicaid
TNG98004Medicare UPIN