MEDICARE: MALIKA TULI 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	207ND0101X	MOHS-Micrographic Surgery Physician	MD 31221	TN
2	207N00000X	Dermatology Physician	MD31221	TN

General Provider Information

NPI Number	:	1659303444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALIKA TULI MD

Provider Business Mailing Address
First Line	:	6644 SUMMER KNOLL CIR
Second Line	:
City	:	BARTLETT
State	:	TN
Zip	:	38134-2875
Country	:	US
Telephone Number	:	901-372-4545
Fax Number	:	901-372-4310

Provider Business Practice Location Address
First Line	:	6644 SUMMER KNOLL CIR
Second Line	:
City	:	BARTLETT
State	:	TN
Zip	:	38134-2875
Country	:	US
Telephone Number	:	901-372-4545
Fax Number	:	901-372-4310

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

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	10/06/2020

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