Provider Demographics
NPI:1073990057
Name:DAS, AVI (MD)
Entity Type:Individual
Prefix:DR
First Name:AVI
Middle Name:
Last Name:DAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1924 ALCOA HWY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1511
Mailing Address - Country:US
Mailing Address - Phone:865-305-9340
Mailing Address - Fax:856-305-9144
Practice Address - Street 1:1924 ALCOA HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920
Practice Address - Country:US
Practice Address - Phone:865-305-9340
Practice Address - Fax:856-305-9144
Is Sole Proprietor?:No
Enumeration Date:2015-04-29
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN57767207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine