Provider Demographics
NPI:1164554572
Name:DAHER, FADI (MD)
Entity Type:Individual
Prefix:
First Name:FADI
Middle Name:
Last Name:DAHER
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 1:176 S BELLEVUE BLVD
Mailing Address - Street 2:SUITE 502
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-3417
Mailing Address - Country:US
Mailing Address - Phone:901-726-1199
Mailing Address - Fax:901-726-0794
Practice Address - Street 1:176 S BELLEVUE BLVD
Practice Address - Street 2:SUITE 502
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3417
Practice Address - Country:US
Practice Address - Phone:901-726-1199
Practice Address - Fax:901-726-0794
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH83463207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine