Provider Demographics
NPI:1730246455
Name:M A M LLC
Entity type:Organization
Organization Name:M A M LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-333-0330
Mailing Address - Street 1:397 WALLACE RD STE C300
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-8020
Mailing Address - Country:US
Mailing Address - Phone:615-333-3033
Mailing Address - Fax:615-333-9912
Practice Address - Street 1:397 WALLACE RD STE C300
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-8020
Practice Address - Country:US
Practice Address - Phone:615-333-3033
Practice Address - Fax:615-333-9912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4080481OtherBLUE CROSS BLUE SHIELD
3725498Medicare PIN