Healthcare Provider Details

I. General information

NPI: 1063716264
Provider Name (Legal Business Name): B M PHYSICIANS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2011
Last Update Date: 08/23/2021
Certification Date: 08/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

943 WHITNEY AVE
MEMPHIS TN
38127-7734
US

IV. Provider business mailing address

943 WHITNEY AVE
MEMPHIS TN
38127-7734
US

V. Phone/Fax

Practice location:
  • Phone: 901-358-0326
  • Fax: 901-358-9010
Mailing address:
  • Phone: 901-358-0326
  • Fax: 901-358-9010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: MOHAMAD MOUGHRABIEH
Title or Position: OWNER
Credential: MD
Phone: 901-358-0326