1588758064 NPI number — NEONATOLOGY CARE PC

Table of content: (NPI 1588758064)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588758064 NPI number — NEONATOLOGY CARE PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEONATOLOGY CARE PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1588758064
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/05/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 90998
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37209
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-342-4661
Provider Business Mailing Address Fax Number:
615-342-4662

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 NORTH HIGHLAND AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MURFREESBORO
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-396-4602
Provider Business Practice Location Address Fax Number:
615-396-4516
Provider Enumeration Date:
10/02/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ISMAIL
Authorized Official First Name:
MUHAMMAD
Authorized Official Middle Name:
SAMI
Authorized Official Title or Position:
PHYSICIAN/OWNER
Authorized Official Telephone Number:
615-342-4661

Provider Taxonomy Codes

  • Taxonomy code: 2080N0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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