Organization
BOULEVARD EAST FAMILY AND OCCUPATIONAL MEDICINE INC
Active
Other names
Moses Benavides MD
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOSES BENAIAH BENAVIDES MD (CEO)
(423) 318-1185
Entity
Organization
Contact information
Practice address
222 BOWMAN ST, SUITE 3, MORRISTOWN, TN 37813-3856
(423) 318-1185
(423) 318-1015
Mailing address
1443 W MORRIS BLVD, SUITE B, MORRISTOWN, TN 37813
(423) 318-1185
(423) 318-1015
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QC1500X
Community Health Clinic/Center
MD0000040290
TN
261QC1800X
Corporate Health Clinic/Center
MD0000040290
TN
261QD0000X
Dental Clinic/Center
DS0000007577
TN
261QM1103X
Military Ambulatory Procedure Visits Operational (Transportable) Clinic/Center
MD0000040290
TN
261QM1300X
Multi-Specialty Clinic/Center
MD 0000040290
TN
261QP2300X
Primary Care Clinic/Center
MD0000040290
TN
261QU0200X
Urgent Care Clinic/Center
MD0000040290
TN
261QX0100X
Occupational Medicine Clinic/Center
MD0000040290
TN
Other
Enumeration date
11/14/2006
Last updated
03/07/2023
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