MEDICARE: CARMEL CLINIC CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	37844	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4143375	OTHER	TN	BCBS
2	4143376	OTHER	TN	BCBS TN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326187980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARMEL CLINIC CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 949
Second Line	:
City	:	SHELBYVILLE
State	:	TN
Zip	:	37162
Country	:	US
Telephone Number	:	931-680-1560
Fax Number	:	931-680-1561

Provider Business Practice Location Address
First Line	:	2762 HWY 231 NORTH
Second Line	:
City	:	SHELBYVILLE
State	:	TN
Zip	:	37160
Country	:	US
Telephone Number	:	931-680-1560
Fax Number	:	931-680-1561

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MUHAMED SALAH FAOUR
Credential	:	MD
Telephone Number	:	931-680-1559

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	01/11/2011

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Directions to “CARMEL CLINIC CORPORATION ” Practice Location

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