Provider Demographics
NPI:1386264067
Name:KNOXVILLE RHEUMATOLOGY PLLC
Entity type:Organization
Organization Name:KNOXVILLE RHEUMATOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MISHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDULLAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-445-0150
Mailing Address - Street 1:12951 SIENA LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-1012
Mailing Address - Country:US
Mailing Address - Phone:716-445-0150
Mailing Address - Fax:
Practice Address - Street 1:2072 LAKESIDE CENTRE WAY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-6591
Practice Address - Country:US
Practice Address - Phone:716-445-0150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty