NPI Code Details Logo

NPI 1417678061

NPI 1417678061 : MR. ADEL EID MAXIMOUS SR. : NASHVILLE, TN

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1417678061
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    MR. ADEL EID MAXIMOUS SR.
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    09/12/2022
-----------------------------------------------------
    Last Update Date     |    11/16/2022
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    3396 WOODLAND STAR WAY 
-----------------------------------------------------
    City                 |    NASHVILLE
-----------------------------------------------------
    State                |    TN
-----------------------------------------------------
    Zip                  |    37207-3381
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    615-335-3650
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    3396 WOODLAND STAR WAY 
-----------------------------------------------------
    City                 |    NASHVILLE
-----------------------------------------------------
    State                |    TN
-----------------------------------------------------
    Zip                  |    37207-3381
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    615-335-3650
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    343900000X
-----------------------------------------------------
    Taxonomy Name        |    Non-emergency Medical Transport (VAN)
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.