Provider Demographics
NPI:1376982744
Name:SYED A NASEERUDDIN MD LLC
Entity Type:Organization
Organization Name:SYED A NASEERUDDIN MD LLC
Other - Org Name:MIDDLE-TN SPORTSMED & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:
Authorized Official - Last Name:NASEERUDDIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-645-6990
Mailing Address - Street 1:1762B MEMORIAL DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-4521
Mailing Address - Country:US
Mailing Address - Phone:931-645-6990
Mailing Address - Fax:931-906-9576
Practice Address - Street 1:1762B MEMORIAL DR
Practice Address - Street 2:SUITE 201
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-4521
Practice Address - Country:US
Practice Address - Phone:931-645-6990
Practice Address - Fax:931-906-9576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Single Specialty