Basic Information
| Provider Information | |||||||||
| NPI: | 1831485788 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABU AL HOMMOS | ||||||||
| FirstName: | NISREEN | ||||||||
| MiddleName: | AWNI DAOUD | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 27892 | ||||||||
| Address2: | |||||||||
| City: | BELFAST | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049152030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9017589900 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1325 EASTMORELAND AVE STE 370 | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381047542 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9017587888 | ||||||||
| FaxNumber: | 9013875153 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2011 | ||||||||
| LastUpdateDate: | 10/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | LL33841 | SC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 51582 | TN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RE0101X | 51582 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
No ID Information.