Provider Demographics
NPI:1417951278
Name:MOHYUDDIN, NAVED M (MD)
Entity Type:Individual
Prefix:
First Name:NAVED
Middle Name:M
Last Name:MOHYUDDIN
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:PO BOX 501123
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-0001
Mailing Address - Country:US
Mailing Address - Phone:615-284-8740
Mailing Address - Fax:615-284-8644
Practice Address - Street 1:2010 CHURCH ST
Practice Address - Street 2:STE 310
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2012
Practice Address - Country:US
Practice Address - Phone:615-284-4672
Practice Address - Fax:615-284-5752
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33905207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN7679297OtherAETNA
TN4169730OtherBLUE CROSS BLUE SHIELD
TN38671832Medicaid
TN7679297OtherAETNA
TN38671832Medicaid