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1285637462

NPI Code Detail

MEDICARE: DR. LAMA MA ELBAHLAWAN MD

MEDICARE: DR. LAMA MA ELBAHLAWAN MD

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
1	2080P0203X	Pediatric Critical Care Medicine Physician	37849	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285637462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAMA MA ELBAHLAWAN MD

Provider Business Mailing Address
First Line	:	262 DANNY THOMAS PL
Second Line	:	MS 515
City	:	MEMPHIS
State	:	TN
Zip	:	38105-3678
Country	:	US
Telephone Number	:	901-595-3006
Fax Number	:	901-595-3842

Provider Business Practice Location Address
First Line	:	262 DANNY THOMAS PL
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38105-3678
Country	:	US
Telephone Number	:	901-595-3006
Fax Number	:	901-595-3842

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	09/28/2012

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Directions to “ DR. LAMA MA ELBAHLAWAN MD” Practice Location

Language	Start Address	Practice Location

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