Basic Information
| Provider Information | |||||||||
| NPI: | 1508381120 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABDEL MASSIH | ||||||||
| FirstName: | SARAH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2002 BROOKSIDE DR, SUITE 102 | ||||||||
| Address2: | |||||||||
| City: | KINGSPORT | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37660 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5059202729 | ||||||||
| FaxNumber: | 4232454190 | ||||||||
| Practice Location | |||||||||
| Address1: | 2002 BROOKSIDE DR STE 102 | ||||||||
| Address2: | |||||||||
| City: | KINGSPORT | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376604634 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4232456000 | ||||||||
| FaxNumber: | 4232454190 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2017 | ||||||||
| LastUpdateDate: | 09/23/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 0116030990 | VA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RN0300X | 64761 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.