Healthcare Provider Details

I. General information

NPI: 1174770895
Provider Name (Legal Business Name): MEENA NARASIMHAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2008
Last Update Date: 08/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8010 STAGE HILLS BLVD
BARTLETT TN
38133-4032
US

IV. Provider business mailing address

7940 FARNIFOLD DR APT # 1
GERMANTOWN TN
38138-5027
US

V. Phone/Fax

Practice location:
  • Phone: 901-291-2400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number43951
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: