Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 63307 | TN |
NPI | 1124400320 |
---|---|
Provider Name | Dr. Ghussai Abd El Gadir |
First Address | Chattanooga, TN 37403-1405 |
Second Address | Chattanooga, TN 37403-1405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2015 |
Last Update Date | 07/01/2022 |