Provider Demographics
NPI:1679078299
Name:ZOLFAGHARI, KAVEH
Entity Type:Individual
Prefix:
First Name:KAVEH
Middle Name:
Last Name:ZOLFAGHARI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 CHESTERFIELD WAY
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-4031
Mailing Address - Country:US
Mailing Address - Phone:615-284-2522
Mailing Address - Fax:
Practice Address - Street 1:5655 FIRST BOULEVARD
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076
Practice Address - Country:US
Practice Address - Phone:615-316-4901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN63810208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist