Basic Information
| Provider Information | |||||||||
| NPI: | 1497802219 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EL-SOURADY | ||||||||
| FirstName: | MAIE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3841 GREEN HILLS VILLAGE DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372152691 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6159362000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1215 21ST AVE S | ||||||||
| Address2: | MEDICAL CENTER EAST-NORTH TOWER, 7TH FLOOR SUITE 2 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372320001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153437584 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2007 | ||||||||
| LastUpdateDate: | 03/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0002X | 44197 | TN | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine | 208000000X | 44197 | TN | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080H0002X | 44197 | TN | N | Allopathic & Osteopathic Physicians | Pediatrics | Hospice and Palliative Medicine | 207R00000X | 44197 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.