MEDICARE: KAUKAB NASEER M.D.

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
1	208000000X	Pediatrics Physician	028243	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326036930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAUKAB NASEER M.D.

Provider Business Mailing Address
First Line	:	6918 SHALLOWFORD RD
Second Line	:	SUITE 206
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-6784
Country	:	US
Telephone Number	:	423-855-2552
Fax Number	:	423-855-9041

Provider Business Practice Location Address
First Line	:	632 MORRISON SPRINGS RD
Second Line	:	SUITE 300
City	:	CHATTANOOGA
State	:	TN
Zip	:	37415-3416
Country	:	US
Telephone Number	:	423-877-4524
Fax Number	:	423-875-5860

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2005
Last Update Date	:	12/10/2012

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