Complete Family Care of Maryville, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25789 Issued in TN

Legal business name

COMPLETE FAMILY CARE OF MARYVILLE, PLLC

Practice address

2004 E. Broadway
Maryville, TN 37804

Phone

(865) 982-4301

NPI assigned

Sep 21, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Andrew O. Sugantharais, MD

Title

Medical Director

Phone

(865) 982-4301

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1285027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285027200000",
    "number": "1184932485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 E. BROADWAY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "37804",
            "telephone_number": "865-982-4301",
            "fax_number": "865-357-8869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 E. BROADWAY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "37804",
            "telephone_number": "865-982-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE FAMILY CARE OF MARYVILLE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-21",
        "last_updated": "2010-09-21",
        "status": "A",
        "authorized_official_last_name": "SUGANTHARAIS",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "865-982-4301",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "25789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Maryville, TN
• Providers in Maryville, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.