Provider Demographics
NPI:1982764593
Name:KANABAR, HASMUKH VANMALI (MD)
Entity Type:Individual
Prefix:
First Name:HASMUKH
Middle Name:VANMALI
Last Name:KANABAR
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 1:1225 E WEISGARBER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2604
Mailing Address - Country:US
Mailing Address - Phone:865-584-4747
Mailing Address - Fax:865-584-1363
Practice Address - Street 1:167 WARREN ST
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37354-3001
Practice Address - Country:US
Practice Address - Phone:423-442-5480
Practice Address - Fax:423-442-4416
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000026806207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
080144900OtherRAILROAD MEDICARE
TN3066220OtherBLUECROSS BLUESHIELD
TN3092494Medicaid
4867910007OtherCIGNA INSURANCE
TN3066220OtherBLUECROSS BLUESHIELD
TNG09624Medicare UPIN