Provider Demographics
NPI:1285799155
Name:GAVAMI, DAVID AFSHIN (OD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:AFSHIN
Last Name:GAVAMI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7909 CONCORD HILLS DR STE 101
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8877
Mailing Address - Country:US
Mailing Address - Phone:615-941-2020
Mailing Address - Fax:615-941-3937
Practice Address - Street 1:7909 CONCORD HILLS DR
Practice Address - Street 2:STE 101
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8877
Practice Address - Country:US
Practice Address - Phone:615-941-2020
Practice Address - Fax:615-941-3937
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1855152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNU68024Medicare UPIN
TN3941577Medicare PIN