Healthcare Provider Details

I. General information

NPI: 1689897159
Provider Name (Legal Business Name): HAFIZ AWAIS ELAHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 01/29/2021
Certification Date: 01/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 CENTERVIEW PKWY STE 305
CORDOVA TN
38018-4225
US

IV. Provider business mailing address

PO BOX 1885
MEMPHIS TN
38101-1885
US

V. Phone/Fax

Practice location:
  • Phone: 901-261-3500
  • Fax: 901-725-8936
Mailing address:
  • Phone: 901-261-3500
  • Fax: 901-725-8936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number42117
License Number StateTN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: