Provider Demographics
NPI:1174780951
Name:KASSIRA, ANNE KANDERIAN (MD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:KANDERIAN
Last Name:KASSIRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:SAMI
Other - Last Name:KANDERIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 415000-MSC8179
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37241-8179
Mailing Address - Country:US
Mailing Address - Phone:865-670-6199
Mailing Address - Fax:865-670-6198
Practice Address - Street 1:1940 ALCOA HWY STE E310
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-2267
Practice Address - Country:US
Practice Address - Phone:865-544-2800
Practice Address - Fax:865-544-6812
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101245765207RC0000X
TN61524207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD418019400Medicaid
VA1174780951Medicaid
VAP00756338OtherRAILROAD MEDICARE
VA1174780951Medicaid
MD418019400Medicaid