Individual
DR. RENA A AZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD PC FPMRS
Contact information
Practice address
325 S CEDAR AVE STE 2, SOUTH PITTSBURG, TN 37380-1322
(423) 837-5801
(423) 837-5807
Mailing address
325 S CEDAR AVE, SUITE 2, SOUTH PITTSBURG, TN 37380-1305
(423) 837-5801
(423) 837-5807
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
MD0000030628
TN
207VG0400X
Gynecology Physician
30628
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3149771
BCBS TN PROV #
TN
01
—
62-1818059
TAX ID
TN
01
—
891-08307
BCBS AL PROV #
AL
Enumeration date
01/24/2007
Last updated
08/16/2021
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