Provider Demographics
NPI:1982864054
Name:UQDAH, JAMEEL AMEER (MD)
Entity Type:Individual
Prefix:
First Name:JAMEEL
Middle Name:AMEER
Last Name:UQDAH
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 1:3452 CHANDLER COVE WAY
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-4576
Mailing Address - Country:US
Mailing Address - Phone:615-668-3546
Mailing Address - Fax:615-668-3546
Practice Address - Street 1:3452 CHANDLER COVE WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-4576
Practice Address - Country:US
Practice Address - Phone:615-668-3546
Practice Address - Fax:615-668-3546
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-34798207R00000X
MS21864207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS04-34798OtherKS LICENSE
KS200713660AMedicaid
MS21864OtherMS LICENSE
MS21864OtherMS LICENSE