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General NPI Number Information
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NPI Number | 1962021493
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Entity Type | Individual
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Provider Name | UPASNA CHANDRASEN BAHURE MD
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Gender | Female
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Dates
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Enumeration Date | 04/14/2020
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Last Update Date | 01/13/2023
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Provider Practice Location Address
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Address Line | 1265 UNION AVE 4 SHORB TOWER
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City | MEMPHIS
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State | TN
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Zip | 38104-3415
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Country | US
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Telephone | 901-478-9183
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Fax | 901-478-8957
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Provider Business Mailing Address
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Address Line | PO BOX 27892
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City | BELFAST
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State | ME
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Zip | 04915-2030
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Country | US
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Telephone | 901-758-9900
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Fax | 901-752-2335
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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 | 204F00000X
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Taxonomy Name | Transplant Surgery Physician
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License Number | 66339
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License Number State | TN
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