1326115577 NPI number — SADIA MAJID DAR MD

Table of content: SADIA MAJID DAR MD (NPI 1326115577)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326115577 NPI number — SADIA MAJID DAR MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DAR
Provider First Name:
SADIA
Provider Middle Name:
MAJID
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326115577
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/18/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1195 OLD HICKORY BLVD
Provider Second Line Business Mailing Address:
SUITE 103
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37027-4239
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-818-9888
Provider Business Mailing Address Fax Number:
615-891-5021

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
515 STONECREST PKWY
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
SMYRNA
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37167-6826
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-223-7227
Provider Business Practice Location Address Fax Number:
615-891-5002
Provider Enumeration Date:
11/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  45525 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 200872970 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1519124 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".




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