Provider Demographics
NPI:1831485788
Name:ABU AL HOMMOS, NISREEN AWNI DAOUD (MD)
Entity Type:Individual
Prefix:
First Name:NISREEN
Middle Name:AWNI DAOUD
Last Name:ABU AL HOMMOS
Suffix:
Gender:F
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 27892
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-2030
Mailing Address - Country:US
Mailing Address - Phone:901-758-9900
Mailing Address - Fax:
Practice Address - Street 1:1325 EASTMORELAND AVE STE 370
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-7542
Practice Address - Country:US
Practice Address - Phone:901-758-7888
Practice Address - Fax:901-387-5153
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL33841207R00000X
TN51582207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine