Simon H Tesfau MD PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

41174 Issued in TN

Legal business name

SIMON H TESFAU MD PC

Practice address

1390 Reserve Dr
Apt 104
Cordova, TN 38016-6300

Phone

(347) 879-2645

NPI assigned

Sep 4, 2008

Last updated

Sep 9, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Simon H Tesfau, MD

Title

Owner/President

Phone

(347) 879-2645

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220918400000",
    "number": "1386892255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 RESERVE DR",
            "address_2": "APT 104",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380166300",
            "telephone_number": "347-879-2645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 RESERVE DR",
            "address_2": "APT 104",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380166300",
            "telephone_number": "347-879-2645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMON H TESFAU MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-04",
        "last_updated": "2008-09-09",
        "status": "A",
        "authorized_official_last_name": "TESFAU",
        "authorized_official_first_name": "SIMON",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "347-879-2645",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "41174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD LICENSE",
            "identifier": "41174",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Cordova, TN
• Providers in Cordova, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.