Healthcare Provider Details

I. General information

NPI: 1598338014
Provider Name (Legal Business Name): FAREEHA ABID MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2021
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S WALNUT BEND RD STE 12
CORDOVA TN
38018-7527
US

IV. Provider business mailing address

276 GRAND CONCOURSE APT 1013
BRONX NY
10451-5850
US

V. Phone/Fax

Practice location:
  • Phone: 901-799-1123
  • Fax: 901-767-0304
Mailing address:
  • Phone: 908-994-5420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number76437
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number36948
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: