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Individual

FAWWAZ A ALKAYYALI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
393 WALLACE RD STE A302, NASHVILLE, TN 37211-4983
(615) 781-1935
(615) 781-1936
Mailing address
PO BOX 110925, NASHVILLE, TN 37222-0925
(615) 781-1935
(615) 781-1936

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
27572
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009941739
AL
05
009975320
AL
01
3097984
MEDICAID PIN
TN
05
3097985
TN
01
3731879
MEDICARE PIN
TN
01
4024735
BCBST
TN
01
890-12152
BCBSAL
AL
01
P00403756
RAILROAD
TN
Enumeration date
05/25/2006
Last updated
03/20/2019
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