Provider Demographics
NPI:1043276322
Name:CEDAR MEDICAL GROUP, PC
Entity Type:Organization
Organization Name:CEDAR MEDICAL GROUP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:HAMADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-220-4747
Mailing Address - Street 1:300 STONECREST BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-5688
Mailing Address - Country:US
Mailing Address - Phone:615-220-4747
Mailing Address - Fax:615-462-0111
Practice Address - Street 1:300 STONECREST BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-5688
Practice Address - Country:US
Practice Address - Phone:615-220-4747
Practice Address - Fax:615-462-0111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25858207Q00000X, 207V00000X
TN31311207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3723472Medicare ID - Type Unspecified