Healthcare Provider Details

I. General information

NPI: 1982672507
Provider Name (Legal Business Name): MUHAMED SALAH FAOUR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 10/31/2022
Certification Date: 10/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2762 HWY 231 NORTH
SHELBYVILLE TN
37160
US

IV. Provider business mailing address

PO BOX 949
SHELBYVILLE TN
37162
US

V. Phone/Fax

Practice location:
  • Phone: 931-680-1559
  • Fax: 931-680-1561
Mailing address:
  • Phone: 931-680-1559
  • Fax: 931-680-1561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberTP142
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number37844
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: