Amro Abujaber

Individual provider Active NPI Private Vehicle · Cordova, TN

NPI 1467919035 · NPPES record last updated Oct 9, 2019

Key facts

NPI
1467919035
Entity type
Individual (NPI type 1)
Primary specialty
Private Vehicle 347C00000X
License
112738177 (TN)
Practice address
2558 Vintage Dr
Cordova, TN 38016-7521
Phone
(731) 935-9578
NPI assigned
Mar 1, 2019
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
112738117TNMDTaxi
112738177TNMDPrivate Vehicle

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Taxi 344600000X 112738117 TN
Private Vehicle 347C00000X 112738177 TN Yes

Addresses

Primary practice location

2558 Vintage Dr
Cordova, TN 38016-7521

Mailing address

2558 Vintage Dr
Cordova, TN 38016-7521
Phone (731) 935-9578

Other providers in Cordova, TN

All providers in Cordova, TN · Private Vehicle in Tennessee

Sources for this page

Verify at the official NPI Registry.