Provider Demographics
NPI:1053600239
Name:FILL, MARY-MARGARET ANNE (MD)
Entity type:Individual
Prefix:
First Name:MARY-MARGARET
Middle Name:ANNE
Last Name:FILL
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1215 21ST AVE S
Mailing Address - Street 2:MCE - NORTH TOWER; 7TH FLOOR, SUITE 2
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-0014
Mailing Address - Country:US
Mailing Address - Phone:615-936-1969
Mailing Address - Fax:615-936-6666
Practice Address - Street 1:1215 21ST AVE S
Practice Address - Street 2:MCE - NORTH TOWER; 7TH FLOOR, SUITE 2
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0014
Practice Address - Country:US
Practice Address - Phone:615-936-1969
Practice Address - Fax:615-936-6666
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-28
Last Update Date:2012-07-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNNOT ISSUED208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics