Provider Demographics
NPI:1407115538
Name:CATHCART, PETER LARS (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:LARS
Last Name:CATHCART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 S 11TH ST STE 101A
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-3131
Mailing Address - Country:US
Mailing Address - Phone:612-616-4664
Mailing Address - Fax:
Practice Address - Street 1:225 S 11TH ST STE 101A
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37206-3131
Practice Address - Country:US
Practice Address - Phone:612-616-4664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN600472080P0204X, 207R00000X
MN61266207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine