Healthcare Provider Details

I. General information

NPI: 1922024686
Provider Name (Legal Business Name): MICHAEL DOUGLAS HELLMAN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 POPLAR AVE #1608
MEMPHIS TN
38157
US

IV. Provider business mailing address

5050 POPLAR AVE #1608
MEMPHIS TN
38157
US

V. Phone/Fax

Practice location:
  • Phone: 901-415-6355
  • Fax: 901-415-6305
Mailing address:
  • Phone: 901-415-6355
  • Fax: 901-415-6305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number9851
License Number StateTN

VIII. Authorized Official

Name: MR. MICHAEL DOUGLAS HELLMAN SR.
Title or Position: PRESIDENT
Credential: MD
Phone: 901-415-6355