Provider Demographics
NPI:1992790174
Name:INTERLANDI, JOHN W (MD)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:W
Last Name:INTERLANDI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:53 CENTURY BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3693
Mailing Address - Country:US
Mailing Address - Phone:615-346-6213
Mailing Address - Fax:615-346-6225
Practice Address - Street 1:3901 CENTRAL PIKE STE 555
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076
Practice Address - Country:US
Practice Address - Phone:615-874-9667
Practice Address - Fax:615-871-9682
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN12079207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3186316Medicaid
TN6060183OtherBLUE CROSS BLUE SHIELD
TNQ019961Medicaid
B04240Medicare UPIN
TN3186316Medicaid
TNQ019961Medicaid