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General NPI Number Information
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NPI Number | 1831485788
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Entity Type | Individual
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Provider Name | NISREEN AWNI DAOUD ABU AL HOMMOS M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/20/2011
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 6401 POPLAR AVE STE 400
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City | MEMPHIS
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State | TN
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Zip | 38119-4806
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Country | US
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Telephone | 901-753-3322
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Fax | 901-753-3323
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Provider Business Mailing Address
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Address Line | 1211 UNION AVE STE 330
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City | MEMPHIS
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State | TN
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Zip | 38104-6655
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Country | US
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Telephone |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | LL33841
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 51582
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 51582
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License Number State | TN
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