Provider Demographics
NPI:1437110467
Name:HIJAZI, RABIH A (MD)
Entity Type:Individual
Prefix:
First Name:RABIH
Middle Name:A
Last Name:HIJAZI
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 1:49 CLEVELAND ST
Mailing Address - Street 2:SUITE 350
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-9716
Mailing Address - Country:US
Mailing Address - Phone:931-456-5184
Mailing Address - Fax:931-456-5226
Practice Address - Street 1:49 CLEVELAND ST
Practice Address - Street 2:SUITE 350
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-9716
Practice Address - Country:US
Practice Address - Phone:931-456-5184
Practice Address - Fax:931-456-5226
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN39247207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
I25627Medicare UPIN
3327794Medicare PIN