Provider Demographics
NPI:1144426081
Name:DAMSHALA, NALINI K (MD)
Entity type:Individual
Prefix:DR
First Name:NALINI
Middle Name:K
Last Name:DAMSHALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NALINI
Other - Middle Name:K
Other - Last Name:DAMSHALA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2825 WESTSIDE DR NW STE C
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-3504
Mailing Address - Country:US
Mailing Address - Phone:423-614-3733
Mailing Address - Fax:423-614-3738
Practice Address - Street 1:2825 WESTSIDE DR NW STE C
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-3504
Practice Address - Country:US
Practice Address - Phone:423-614-3733
Practice Address - Fax:423-614-3738
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21336174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNF19025Medicare UPIN