Individual
MR. ABU S FAKHRUDDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
330 23RD AVE N, SUITE 300, NASHVILLE, TN 37203-1534
(615) 342-5900
(615) 342-7898
Mailing address
330 23RD AVE N, SUITE 300, NASHVILLE, TN 37203-1534
(615) 342-5900
(615) 342-7898
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD26195
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100015511
RR MEDICARE
TN
05
—
3805808
—
TN
05
—
64032071
—
KY
Enumeration date
09/16/2005
Last updated
01/24/2022
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