Healthcare Provider Details

I. General information

NPI: 1093197212
Provider Name (Legal Business Name): ALI H BEDAIR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ALI ELSAYES

II. Dates (important events)

Enumeration Date: 06/24/2015
Last Update Date: 07/01/2021
Certification Date: 07/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6019 WALNUT GROVE RD
MEMPHIS TN
38120
US

IV. Provider business mailing address

5100 POPLAR AVE STE 2722
MEMPHIS TN
38137
US

V. Phone/Fax

Practice location:
  • Phone: 901-226-5000
  • Fax: 615-936-3412
Mailing address:
  • Phone: 901-818-2160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number60080
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number60080
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: