Organization
SIMON H TESFAU MD PC
Active
Organization
SIMON H TESFAU MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIMON H TESFAU MD (OWNER/PRESIDENT)
(347) 879-2645
Entity
Organization
Contact information
Practice address
1390 RESERVE DR, APT 104, CORDOVA, TN 38016-6300
(347) 879-2645
Mailing address
1390 RESERVE DR, APT 104, CORDOVA, TN 38016-6300
(347) 879-2645
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
41174
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41174
MD LICENSE
TN
Enumeration date
09/04/2008
Last updated
09/09/2008
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