Organization
QLER PHYSICIAN MEDICAL GROUP, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DWAYNE AVANISH NARAYAN MD (CHIEF CLINICAL OFFICER)
(240) 285-5396
Entity
Organization
Contact information
Practice address
4431 ADRIENNE CT, JEFFERSON, MD 21755
(240) 285-5396
Mailing address
200 W MARTIN LUTHER KING BLVD, CHATTANOOGA, TN 37402-2560
(240) 285-5396
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
07/07/2017
Last updated
06/30/2022
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