Provider Demographics
NPI:1962517045
Name:PERSAD, PAUL (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:PERSAD
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 1:1916 PATTERSON ST
Mailing Address - Street 2:STE 501
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2120
Mailing Address - Country:US
Mailing Address - Phone:615-321-5729
Mailing Address - Fax:
Practice Address - Street 1:1916 PATTERSON ST
Practice Address - Street 2:STE 501
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2120
Practice Address - Country:US
Practice Address - Phone:615-321-5729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2011-01924207ZP0101X
TN52535207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA481755057BMedicaid
GA11SCGKNMedicare PIN