Individual
MARY AXELRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4848 FORT HENRY DR, KINGSPORT, TN 37663-3347
(423) 239-5141
(423) 239-4869
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2093
(423) 390-3340
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
58418
TN
Other
Enumeration date
03/23/2016
Last updated
01/16/2024
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