Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 56781 | TN |
N | 207RC0000X | Internist - Cardiovascular Disease | 56781 | TN |
NPI | 1619154358 |
---|---|
Provider Name | Muddassir Mehmood |
First Address | Knoxville, TN 37920-2267 |
Second Address | Knoxville, TN 37920-2267 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2008 |
Last Update Date | 24/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1619154358 | (05) | NC |
3072571 | (05) | OH |
NC2790 | (05) | SC |