Healthcare Provider Details

I. General information

NPI: 1265658629
Provider Name (Legal Business Name): PETER H LAW M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 11/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 POPLAR AVE SUITE 800
MEMPHIS TN
38157-0101
US

IV. Provider business mailing address

5050 POPLAR AVE SUITE 800
MEMPHIS TN
38157-0101
US

V. Phone/Fax

Practice location:
  • Phone: 901-276-2662
  • Fax: 901-274-2033
Mailing address:
  • Phone: 901-276-2662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number46627
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number46627
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number46627
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: