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General NPI Number Information
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NPI Number | 1740462464
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Entity Type | Individual
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Provider Name | PARVIZ GHOLAMI MD
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Gender | Male
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Dates
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Enumeration Date | 12/04/2007
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 1 MEDICAL PARK BLVD
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City | BRISTOL
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State | TN
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Zip | 37620-7430
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Country | US
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Telephone | 423-844-1121
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Fax |
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Provider Business Mailing Address
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Address Line | 1021 W OAKLAND AVE STE 310
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City | JOHNSON CITY
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State | TN
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Zip | 37604-2192
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Country | US
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Telephone | 423-302-6565
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 13385
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 64913
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 348758
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License Number State | LA
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A101582
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101245692
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License Number State | VA
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Taxonomy #6
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 2024041759
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License Number State | MO
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