Chismar, Larissa Ann

Chismar, Larissa Ann is an individual health care provider with primary practice located at 5301 Virginia Way Ste 300 , Brentwood TN 37027-7542. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Dermatopathology. Allopathic & Osteopathic Physicians / Dermatopathology is her primary health care specialty. Chismar, Larissa Ann can be contacted via phone (615) 695-4977.

Contact Information

Primary practice address
5301 Virginia Way Ste 300 Brentwood TN 37027-7542
Phone: (615) 695-4977
Fax: (615) 263-3348
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Dermatopathology 207ZD0900X 073928 Georgia

Profile Details

NPI number 1275854333
LBN Legal business name Chismar, Larissa Ann
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 11th, 2010
Last updated Jul 21st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275854333 NPPES
Georgia MEDICAID 003162891A

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