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NPI Code Detail

MEDICARE: TOTS 2 TEENS LLC

MEDICARE: TOTS 2 TEENS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician37838TN

General Provider Information

NPI Number : 1033516661
Entity Type Code : Organization
Provider Name (Legal Business Name) : TOTS 2 TEENS LLC
Provider Business Mailing Address
First Line : 268 VETERANS PKWY
Second Line : SUITE F
City : MURFREESBORO
State : TN
Zip : 37128-6431
Country : US
Telephone Number : 931-685-8787
Fax Number : 931-685-8786
Provider Business Practice Location Address
First Line : 268 VETERANS PKWY
Second Line : SUITE F
City : MURFREESBORO
State : TN
Zip : 37128-6431
Country : US
Telephone Number : 931-685-8787
Fax Number : 931-685-8786
Authorized Official
Title or Position : PHYSICIAN
Name : MR. SAMER LOLEH
Credential : MD
Telephone Number : 931-685-8787
Provider Enumeration Date : 11/25/2014
Last Update Date : 11/25/2014

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