Healthcare Provider Details

I. General information

NPI: 1063358091
Provider Name (Legal Business Name): SHEMARIAH KENTISH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 MADISON AVE STE 530
MEMPHIS TN
38103-3403
US

IV. Provider business mailing address

910 MADISON AVE STE 530 2ND FLOOR
MEMPHIS TN
38103-3403
US

V. Phone/Fax

Practice location:
  • Phone: 757-355-2954
  • Fax:
Mailing address:
  • Phone: 901-448-7635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: