Healthcare Provider Details

I. General information

NPI: 1326187980
Provider Name (Legal Business Name): CARMEL CLINIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 01/11/2011
Certification Date:
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: 931-680-1560
  • Fax: 931-680-1561
Mailing address:
  • Phone: 931-680-1560
  • Fax: 931-680-1561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number37844
License Number StateTN

VIII. Authorized Official

Name: MR. MUHAMED SALAH FAOUR
Title or Position: OWNER
Credential: MD
Phone: 931-680-1559