Healthcare Provider Details

I. General information

NPI: 1780373357
Provider Name (Legal Business Name): JAIMIN MAHESHBHAI PANDYA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2023
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

262 DANNY THOMAS PL # MS 515
MEMPHIS TN
38105-3678
US

IV. Provider business mailing address

262 DANNY THOMAS PL # MS 515
MEMPHIS TN
38105-3678
US

V. Phone/Fax

Practice location:
  • Phone: 901-307-6345
  • Fax: 888-226-4343
Mailing address:
  • Phone: 901-307-6345
  • Fax: 888-226-4343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number76578
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: