Basic Information
| Provider Information | |||||||||
| NPI: | 1558618553 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MEHARRY MEDICAL COLLEGE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1005 DR. D.B TODD JR. BLVD | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372083599 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153276168 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1005 DR. D.B TODD JR. BLVD | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372083599 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153276168 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2012 | ||||||||
| LastUpdateDate: | 10/06/2012 | ||||||||
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| AuthorizedOfficialLastName: | AL RABADI | ||||||||
| AuthorizedOfficialFirstName: | ISSA | ||||||||
| AuthorizedOfficialMiddleName: | YOUSEF | ||||||||
| AuthorizedOfficialTitleorPosition: | MEDICAL RESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6153276168 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
No ID Information.