Basic Information
| Provider Information | |||||||||
| NPI: | 1770961617 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARMEZY | ||||||||
| FirstName: | BENJAMIN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2004 HAYES ST | ||||||||
| Address2: | SUITE 800 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153290570 | ||||||||
| FaxNumber: | 6153290579 | ||||||||
| Practice Location | |||||||||
| Address1: | 250 25TH AVE. N | ||||||||
| Address2: | STE 200 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6159864366 | ||||||||
| FaxNumber: | 6153201617 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2015 | ||||||||
| LastUpdateDate: | 06/30/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | R7740 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 390200000X | 4301106990 | MI | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RH0003X | 63357 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 8LB694 | 01 | TX | BCBS | OTHER | 398423902 | 05 | TX | MEDICAID | 398423901 | 05 | TX | MEDICAID |