Provider Demographics
NPI:1093322141
Name:ABBAS AGHA MD PLLC
Entity Type:Organization
Organization Name:ABBAS AGHA MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:A
Authorized Official - Last Name:ABBAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-667-8912
Mailing Address - Street 1:2292 CHAMBLISS AVE NW STE F
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37311-3862
Mailing Address - Country:US
Mailing Address - Phone:423-641-4261
Mailing Address - Fax:877-370-2529
Practice Address - Street 1:2292 CHAMBLISS AVE NW STE F
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-3862
Practice Address - Country:US
Practice Address - Phone:423-641-4261
Practice Address - Fax:877-370-2529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-23
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty