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General NPI Number Information
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NPI Number | 1619416633
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Entity Type | Organization
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Legal Business Name | P PUSHPANSHU MD PLLC
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Dates
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Enumeration Date | 02/23/2017
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Last Update Date | 03/28/2017
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Provider Practice Location Address
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Address Line | 495 HUNTERS MILL CV
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City | COLLIERVILLE
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State | TN
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Zip | 38017-2434
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Country | US
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Telephone | 901-826-1977
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Fax |
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Provider Business Mailing Address
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Address Line | 495 HUNTERS MILL CV
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City | COLLIERVILLE
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State | TN
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Zip | 38017-2434
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Country | US
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Telephone | 901-826-1977
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PUSHPANSHU PUSHPANSHU
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Credential | M.D.
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Telephone | 901-826-1977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD29566
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License Number State | TN
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