Individual
DR. CQRNELL CHARLES FAQUIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2749 HUNTERS DR, GERMANTOWN, TN 38138-6224
(901) 755-4387
(901) 755-0718
Mailing address
2749 HUNTERS DR, GERMANTOWN, TN 38138-6224
(901) 755-4387
(901) 755-0718
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD3354
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD3354
STATE LICENSE
TN
Enumeration date
03/10/2007
Last updated
07/08/2007
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