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General NPI Number Information
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NPI Number | 1255607164
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Entity Type | Individual
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Provider Name | DMITRY M YARANOV MD
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Gender | Male
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Dates
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Enumeration Date | 03/25/2012
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 6027 WALNUT GROVE RD STE 112
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City | MEMPHIS
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State | TN
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Zip | 38120-2115
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Country | US
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Telephone | 901-271-1000
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Fax | 901-271-4187
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Provider Business Mailing Address
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Address Line | 8060 WOLF RIVER BLVD
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City | GERMANTOWN
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State | TN
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Zip | 38138-1727
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Country | US
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Telephone | 901-271-1000
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Fax | 901-271-4187
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | E-13438
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 59402
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207RA0001X
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Taxonomy Name | Advanced Heart Failure and Transplant Cardiology Physician
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License Number | 59402
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License Number State | TN
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