Basic Information
Provider Information
NPI: 1265621072
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABU-ZEITOON
FirstName: RAWAN
MiddleName: GHAZI
NamePrefix: DR.
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 105 W STONE DR
Address2: SUITE 6A
City: KINGSPORT
State: TN
PostalCode: 376603365
CountryCode: US
TelephoneNumber: 4234087220
FaxNumber: 4234087405
Practice Location
Address1: 130 W RAVINE RD
Address2:  
City: KINGSPORT
State: TN
PostalCode: 376603837
CountryCode: US
TelephoneNumber: 4232821480
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/17/2007
LastUpdateDate: 12/05/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X46364TNY Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X46364TNN Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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