Healthcare Provider Details

I. General information

NPI: 1366234619
Provider Name (Legal Business Name): CORDIAL HEALTH TN PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 05/21/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 MADISON AVENUE STE 2340
MEMPHIS TN
38104-2620
US

IV. Provider business mailing address

1910 MADISON AVE STE 2340
MEMPHIS TN
38104-2620
US

V. Phone/Fax

Practice location:
  • Phone: 347-667-7924
  • Fax: 332-262-2396
Mailing address:
  • Phone: 347-667-7924
  • Fax: 332-262-2396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MAHMOOD MEHDI KAZMI
Title or Position: OWNER
Credential: MD
Phone: 347-667-7924