Healthcare Provider Details

I. General information

NPI: 1497730964
Provider Name (Legal Business Name): MOHAN M GEHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 10/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7205 WOLF RIVER BLVD SUITE 100
MEMPHIS TN
38138-1758
US

IV. Provider business mailing address

PO BOX 405827
ATLANTA GA
30384-5827
US

V. Phone/Fax

Practice location:
  • Phone: 901-684-1322
  • Fax: 901-682-6368
Mailing address:
  • Phone: 870-934-5821
  • Fax: 870-934-5384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD09965
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: