| Doctor Name: | MR. MICHAEL WARREN |
| NPI Number: | 1023340809 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | PA2532 |
| Business Practice Address: | 3939 Central Pike Hermitage, TN - 370763499 |
| Business Phone Number: | 6158832331 |
| Business Fax Number: | 6153911785 |
| Mailing Address: | 3939 Central Pike, HERMITAGE |
| State: | TN |
| Postal Code: | 370763499 |
| Phone Number: | 6158832331 |
| Fax Number: | 6153911785 |
| NPI Enumeration Date: | 02/04/2010 |
| NPI Last Update Date: | 01/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA2532 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |