Healthcare Provider Details

I. General information

NPI: 1548212665
Provider Name (Legal Business Name): SHADI M. KARABSHEH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 11/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

765 FLORENCE RD
SAVANNAH TN
38372-3101
US

IV. Provider business mailing address

341 SOMERSET LOOP
SAVANNAH TN
38372-7715
US

V. Phone/Fax

Practice location:
  • Phone: 731-925-2300
  • Fax: 731-925-2157
Mailing address:
  • Phone: 731-926-2351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number37658
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number6664387-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: