MEDICARE: MOHAMED AWAD SIDDIG

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	343900000X	Non-emergency Medical Transport (VAN)	199903	TN

General Provider Information

NPI Number	:	1659801595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMED AWAD SIDDIG

Provider Business Mailing Address
First Line	:	PO BOX 111382
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37222-1382
Country	:	US
Telephone Number	:	615-919-4641
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 WHISPERING HILLS DR APT R10
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-5244
Country	:	US
Telephone Number	:	615-919-4641
Fax Number	:

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

Provider Enumeration Date	:	06/13/2017
Last Update Date	:	06/13/2017

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Directions to “ MOHAMED AWAD SIDDIG ” Practice Location

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