Provider Demographics
NPI:1982672507
Name:FAOUR, MUHAMED SALAH (MD)
Entity Type:Individual
Prefix:MR
First Name:MUHAMED
Middle Name:SALAH
Last Name:FAOUR
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 949
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37162
Mailing Address - Country:US
Mailing Address - Phone:931-680-1559
Mailing Address - Fax:931-680-1561
Practice Address - Street 1:2762 HWY 231 NORTH
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160
Practice Address - Country:US
Practice Address - Phone:931-680-1559
Practice Address - Fax:931-680-1561
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP142207P00000X
TN37844207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3889744Medicaid
TN3889742Medicaid
TN4143376OtherBCBS
TN3889744Medicaid
TNH89958Medicare UPIN
TN3889742Medicaid