Individual
SAMEENA WAHEED KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
150 E SWAN ST, CENTERVILLE, TN 37033-1446
(931) 729-3091
(931) 729-0809
Mailing address
150 E SWAN ST, CENTERVILLE, TN 37033-1446
(931) 729-3091
(931) 729-0809
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
001615
GA
207R00000X
Internal Medicine Physician
Primary
MD43967
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1510125
—
TN
01
—
3002528
MEDICARE PTAN
TN
Enumeration date
04/01/2008
Last updated
12/18/2009
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