Basic Information
Provider Information
NPI: 1023105152
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARILDSEN
FirstName: MARY ANN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD, PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3841 GREEN HILLS VILLAGE DR STE 200
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372152691
CountryCode: US
TelephoneNumber: 6153223000
FaxNumber:  
Practice Location
Address1: 3601 TVC
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372320001
CountryCode: US
TelephoneNumber: 6153223000
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/09/2006
LastUpdateDate: 03/23/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/23/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0102XMD32277TNN Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
207ZH0000XMD32277TNY Allopathic & Osteopathic PhysiciansPathologyHematology

No ID Information.


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