Provider Demographics
NPI:1740513522
Name:KHODER, WASEEM (MD)
Entity type:Individual
Prefix:
First Name:WASEEM
Middle Name:
Last Name:KHODER
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 1:1005 DR. D.B. TODD JR. BLVD.
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37208
Mailing Address - Country:US
Mailing Address - Phone:615-327-6348
Mailing Address - Fax:615-327-5858
Practice Address - Street 1:1005 DR. D.B. TODD JR. BLVD.
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208
Practice Address - Country:US
Practice Address - Phone:615-327-6348
Practice Address - Fax:615-327-5858
Is Sole Proprietor?:No
Enumeration Date:2009-09-11
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45196207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology