Individual
KASSEM BOURGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
442 METROPLEX DR STE 200, NASHVILLE, TN 37211-3112
(615) 499-7406
(833) 968-2944
Mailing address
PO BOX 31609, BELFAST, ME 04915-0169
(615) 499-7406
(833) 968-2944
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301100453
MI
207R00000X
Internal Medicine Physician
71966
TN
207RI0200X
Infectious Disease Physician
01080959A
IN
207RI0200X
Infectious Disease Physician
Primary
71966
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068010534
MEDICARE PTAN
IN
01
—
264910199
MEDICARE PTAN
IN
05
—
300017285
—
IN
01
—
Q00008371
RAILROAD PTAN
IN
Enumeration date
06/28/2012
Last updated
12/05/2024
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