Provider Demographics
NPI:1972553907
Name:PRITCHARD, BRENDA N (MD)
Entity type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:N
Last Name:PRITCHARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:753 JOHNNIE DODDS BLVD
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3054
Mailing Address - Country:US
Mailing Address - Phone:843-284-3400
Mailing Address - Fax:843-284-3401
Practice Address - Street 1:501 19TH ST
Practice Address - Street 2:SUITE 301
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-1854
Practice Address - Country:US
Practice Address - Phone:865-522-7591
Practice Address - Fax:865-546-2618
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21210207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS11074OtherMS MEDICAL LICENSE
TN21210OtherTN MEDICAL LICENSE
KY64916562Medicaid
TN3028702OtherBCBS
TN4048784OtherBCBS
TN3061750Medicaid
KY64916562Medicaid
TN21210OtherTN MEDICAL LICENSE