Healthcare Provider Details

I. General information

NPI: 1326246737
Provider Name (Legal Business Name): ALYSSA MICHELLE FEINER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 06/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 COLLINS ST
MEMPHIS TN
38112-3810
US

IV. Provider business mailing address

5680 SHADY GROVE RD
MEMPHIS TN
38120-2424
US

V. Phone/Fax

Practice location:
  • Phone: 866-957-0425
  • Fax:
Mailing address:
  • Phone: 901-761-7801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number46681
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: