Individual
WAEL KHALED EL MINAOUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.
Contact information
Practice address
16000 JOHNSTON MEMORIAL DR STE 312D, ABINGDON, VA 24211-7664
(276) 258-1000
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
2019-01775
NC
207RP1001X
Pulmonary Disease Physician
0101268170
VA
207RP1001X
Pulmonary Disease Physician
Primary
2019-01775
NC
207RP1001X
Pulmonary Disease Physician
44003
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103G705049
MEDICARE GROUP
TN
Enumeration date
10/09/2007
Last updated
08/28/2024
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