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NPI Code Detail

MEDICARE: DR. ANNA MARIA DURHAM M.D.

MEDICARE: DR. ANNA MARIA DURHAM M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianMD27029TN
2208000000XPediatrics PhysicianMD16131MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033102066
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANNA MARIA DURHAM M.D.
Provider Business Mailing Address
First Line : 1129 HALE RD
Second Line :
City : MEMPHIS
State : TN
Zip : 38116-6373
Country : US
Telephone Number : 901-396-0390
Fax Number : 901-396-8151
Provider Business Practice Location Address
First Line : 1129 HALE RD
Second Line :
City : MEMPHIS
State : TN
Zip : 38116-6373
Country : US
Telephone Number : 901-396-0390
Fax Number : 901-396-8151
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2005
Last Update Date : 07/08/2007

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