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General NPI Number Information
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NPI Number | 1164795159
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Entity Type | Organization
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Legal Business Name | TENNESSEE NEPHROLOGY CLINIC, PLLC
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Dates
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Enumeration Date | 02/22/2012
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 714 E HARPER AVE
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City | MARYVILLE
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State | TN
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Zip | 37804-4028
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Country | US
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Telephone | 865-238-6580
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Fax | 865-238-6585
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Provider Business Mailing Address
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Address Line | 6311 KINGSTON PIKE STE 26
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City | KNOXVILLE
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State | TN
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Zip | 37919-4900
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Country | US
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Telephone | 865-238-6580
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Fax | 865-238-6585
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Authorized Official
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Title or Position | OWNER
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Name | MOHAMMAD JAVEED SHAFI
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Credential | M.D.
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Telephone | 865-982-5044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | MD30912
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License Number State | TN
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