Individual
MEHRAN MONAZAM TAVALLAEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
133 HAYES ST, CROSSVILLE, TN 38555-8000
(931) 456-9434
(931) 456-5061
Mailing address
49 CLEVELAND ST, SUITE 350, CROSSVILLE, TN 38555-9716
(931) 456-9434
(931) 456-5061
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD42358
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3000369
—
TN
Enumeration date
06/27/2007
Last updated
12/29/2009
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