Provider Demographics
NPI:1982903753
Name:POTENZIANI PRADELLA, SILVIA DANIELA (MD)
Entity type:Individual
Prefix:
First Name:SILVIA
Middle Name:DANIELA
Last Name:POTENZIANI PRADELLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 CHURCH ST STE 615
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2031
Mailing Address - Country:US
Mailing Address - Phone:615-284-7952
Mailing Address - Fax:615-284-5750
Practice Address - Street 1:2000 CHURCH ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37236-4400
Practice Address - Country:US
Practice Address - Phone:615-284-5229
Practice Address - Fax:615-284-4373
Is Sole Proprietor?:No
Enumeration Date:2011-03-19
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN54207207ZD0900X
TNMD0000054207207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ022851Medicaid