Provider Demographics
NPI:1780765461
Name:EL-CHEMEITELLI, SAMER A (MD)
Entity type:Individual
Prefix:
First Name:SAMER
Middle Name:A
Last Name:EL-CHEMEITELLI
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 1:525 DEVONIA ST STE A
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:TN
Mailing Address - Zip Code:37748-2163
Mailing Address - Country:US
Mailing Address - Phone:865-882-0046
Mailing Address - Fax:
Practice Address - Street 1:525 DEVONIA ST STE A
Practice Address - Street 2:
Practice Address - City:HARRIMAN
Practice Address - State:TN
Practice Address - Zip Code:37748-2163
Practice Address - Country:US
Practice Address - Phone:865-882-0046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000041558208M00000X
TN41558207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNMD0000041558OtherMEDICAL LICENSE NUMBER
TN38338942Medicare PIN
TNMD0000041558OtherMEDICAL LICENSE NUMBER
TN3734041Medicare PIN