Healthcare Provider Details

I. General information

NPI: 1013399575
Provider Name (Legal Business Name): ENAMBIR SINGH JOSAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2015
Last Update Date: 07/14/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1940 ALCOA HWY STE E210
KNOXVILLE TN
37920-2264
US

IV. Provider business mailing address

1940 ALCOA HWY STE E210
KNOXVILLE TN
37920-2264
US

V. Phone/Fax

Practice location:
  • Phone: 865-524-7471
  • Fax: 865-305-6563
Mailing address:
  • Phone: 865-524-7471
  • Fax: 865-305-6563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number65886
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number65886
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: