Healthcare Provider Details

I. General information

NPI: 1104760396
Provider Name (Legal Business Name): VALJI MEDICAL GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7714 CONNER RD STE 107
POWELL TN
37849-3559
US

IV. Provider business mailing address

7714 CONNER RD STE 107
POWELL TN
37849-3559
US

V. Phone/Fax

Practice location:
  • Phone: 865-309-9866
  • Fax:
Mailing address:
  • Phone: 865-309-9866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SHAAN VALJI
Title or Position: OWNER
Credential: MD
Phone: 865-309-9866