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General NPI Number Information
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NPI Number | 1962453225
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Entity Type | Individual
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Provider Name | AHSAN H KATHAWALA M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1264 WESLEY DR SUITE 501
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City | MEMPHIS
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State | TN
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Zip | 38116-6400
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Country | US
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Telephone | 901-346-1800
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Fax | 901-346-0043
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Provider Business Mailing Address
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Address Line | PO BOX 383317
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City | GERMANTOWN
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State | TN
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Zip | 38183-3317
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Country | US
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Telephone | 901-346-1800
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Fax | 901-346-0043
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD0000028245
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License Number State | TN
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