Provider Demographics
NPI:1811512197
Name:KANTEMYR, SOPHIA (MD)
Entity type:Individual
Prefix:MRS
First Name:SOPHIA
Middle Name:
Last Name:KANTEMYR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:SOPHIA
Other - Middle Name:
Other - Last Name:KANTYMYR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5651 FRIST BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-2059
Mailing Address - Country:US
Mailing Address - Phone:615-874-8006
Mailing Address - Fax:615-316-4026
Practice Address - Street 1:5651 FRIST BLVD STE 500
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-2059
Practice Address - Country:US
Practice Address - Phone:615-874-8006
Practice Address - Fax:615-316-4026
Is Sole Proprietor?:No
Enumeration Date:2020-06-11
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN71284207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology