Mary M Huizinga, MD
Individual provider Active NPI Internal Medicine Physician · Nashville, TN
NPI 1083761969 · NPPES record last updated Apr 11, 2013
Key facts
- NPI
- 1083761969
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- MD39522 (TN)
- Practice address
- 3601 TVC
Nashville, TN 37232-0001 - Phone
- (615) 322-3000
- NPI assigned
- Jan 4, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D67549 | MD | MD | Internal Medicine Physician |
| MD39522 | TN | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children and Adults Medical Group, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | D67549 | MD | |
| Gastroenterology Physician | 207RG0100X | D67549 | MD | |
| Internal Medicine Physician | 207R00000X | MD39522 | TN | Yes |
Addresses
Primary practice location
3601 TVC
Nashville, TN 37232-0001
Mailing address
3601 TVC
Nashville, TN 37232-0001
Phone (615) 322-3000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4158712 | Other | TN | BLUE CROSS |
| 3000699 | Medicaid | TN | |
| 9587074 | Other | AETNA | |
| 416420200 | Medicaid | MD |
Other providers in Nashville, TN
- Hughston Clinic Southeast PC
- Hughston Clinic Southeast, PC
- Hughston Clinic Southeast,PC
- Austin Gregory Huibers
- Caren Jo Huitt
- Randall Hulet
- Todd Hulgan
- Ann Hull
- Bethany Hull
- Grayson Leigh Hull
All providers in Nashville, TN · Internal Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.