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General NPI Number Information
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NPI Number | 1386264067
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Entity Type | Organization
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Legal Business Name | KNOXVILLE RHEUMATOLOGY PLLC
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Dates
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Enumeration Date | 04/22/2020
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Last Update Date | 04/22/2020
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Provider Practice Location Address
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Address Line | 2072 LAKESIDE CENTRE WAY
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City | KNOXVILLE
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State | TN
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Zip | 37922-6591
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Country | US
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Telephone | 716-445-0150
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Fax |
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Provider Business Mailing Address
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Address Line | 12951 SIENA LN
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City | KNOXVILLE
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State | TN
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Zip | 37934-1012
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Country | US
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Telephone | 716-445-0150
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISHAL ABDULLAH
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Credential | MD
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Telephone | 716-445-0150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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