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Individual

MOHAMMED HUMAYUN KABIR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
486 S FLORENCE AVE, JELLICO, TN 37762-2382
(423) 784-1197
(423) 784-1123
Mailing address
486 S FLORENCE AVE, JELLICO, TN 37762-2382
(423) 784-1197
(423) 784-1123

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD0000026093
TN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD0000026093
TN
207RP1001X
Pulmonary Disease Physician
Primary
43944
KY
207RP1001X
Pulmonary Disease Physician
MD0000026093
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100021371
TN
01
3072339
BCBST
TN
05
3072339
TN
01
4160871
BCBS
TN
05
4160871
TN
05
64920614
KY
05
TN0103
TN
Enumeration date
07/03/2006
Last updated
09/13/2016
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