Basic Information
| Provider Information | |||||||||
| NPI: | 1053974998 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PIETRINI | ||||||||
| FirstName: | NICHOLAS | ||||||||
| MiddleName: | JAMES | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 719 THOMPSON LANE | ||||||||
| Address2: | IM RESIDENT CLINIC - SUITE 3A | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6159361212 | ||||||||
| FaxNumber: | 6159361031 | ||||||||
| Practice Location | |||||||||
| Address1: | 1500 E MEDICAL CENTER DR | ||||||||
| Address2: | |||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481095000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8882871082 | ||||||||
| FaxNumber: | 7342324505 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2019 | ||||||||
| LastUpdateDate: | 06/15/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.