Individual
SAM SADEGHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
135 W RAVINE RD, SUITE 5A, KINGSPORT, TN 37660-3847
(423) 224-3500
(423) 224-3506
Mailing address
105 W STONE DR, SUITE 6A, KINGSPORT, TN 37660-3365
(423) 408-7220
(423) 408-7405
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
40325
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010213100
—
VA
05
—
7100029070
—
KY
Enumeration date
03/14/2006
Last updated
03/28/2014
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