Provider Demographics
NPI:1316234974
Name:POURPAKI, MARYAM (MD)
Entity type:Individual
Prefix:DR
First Name:MARYAM
Middle Name:
Last Name:POURPAKI
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Gender:F
Credentials:MD
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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:37205-2382
Mailing Address - Country:US
Mailing Address - Phone:615-386-2361
Mailing Address - Fax:615-386-2399
Practice Address - Street 1:4230 HARDING PIKE STE 301
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2098
Practice Address - Country:US
Practice Address - Phone:615-964-5823
Practice Address - Fax:615-577-1696
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2019-12-18
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Provider Licenses
StateLicense IDTaxonomies
TN59857207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology