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General NPI Number Information
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NPI Number | 1881686814
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Entity Type | Organization
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Legal Business Name | PEDIATRIC SEDATION SPECIALISTS, PC
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Dates
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Enumeration Date | 08/16/2005
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Last Update Date | 08/01/2007
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Provider Practice Location Address
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Address Line | 50 N DUNLAP ST
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City | MEMPHIS
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State | TN
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Zip | 38103-2800
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Country | US
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Telephone | 901-869-5708
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 342767
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City | BARTLETT
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State | TN
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Zip | 38184-2767
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Country | US
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Telephone | 901-291-2400
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Fax | 901-379-0771
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARTIN I HERMAN
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Credential | MD
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Telephone | 901-869-5708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PP0204X
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Taxonomy Name | Pediatric Emergency Medicine (Emergency Medicine) Physician
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License Number |
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License Number State |
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