Individual
FATIMA ILYAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.B;B.S
Contact information
Practice address
7565 DANNAHER DR, POWELL, TN 37849-4029
(865) 859-8000
Mailing address
7565 DANNAHER DR, POWELL, TN 37849-4029
(865) 859-8000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
56825
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2014
Last updated
05/02/2019
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