Basic Information
Provider Information
NPI: 1083659163
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KUZUR
FirstName: MICHEL
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 440100
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372440100
CountryCode: US
TelephoneNumber: 6153290570
FaxNumber:  
Practice Location
Address1: 3443 DICKERSON PIKE
Address2: STE 760
City: NASHVILLE
State: TN
PostalCode: 372072519
CountryCode: US
TelephoneNumber: 6158601556
FaxNumber: 6158601558
Other Information
ProviderEnumerationDate: 06/20/2006
LastUpdateDate: 01/25/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RX0202X10614TNY Allopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology

ID Information
IDTypeStateIssuerDescription
12068701 BCBS OF TNOTHER
407093401 AETNAOTHER
6492640505KY MEDICAID
317273105TN MEDICAID
90000078801 RAILROAD MEDICAREOTHER
364006401 UNITED HEALTHCAREOTHER


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