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NPI Code Detail

MEDICARE: THOMAS DEAN HERLEVICH MD

MEDICARE: THOMAS DEAN HERLEVICH 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
1207PE0004XEmergency Medical Services (Emergency Medicine) Physician72956TN
2207P00000XEmergency Medicine Physician2026-01953NC

General Provider Information

NPI Number : 1902542368
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS DEAN HERLEVICH MD
Provider Business Mailing Address
First Line : 251 S CLAYBROOK ST STE A206
Second Line :
City : MEMPHIS
State : TN
Zip : 38104-3539
Country : US
Telephone Number : 901-516-7509
Fax Number :
Provider Business Practice Location Address
First Line : 920 MADISON AVE STE 447
Second Line :
City : MEMPHIS
State : TN
Zip : 38103-3438
Country : US
Telephone Number : 901-516-7509
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2022
Last Update Date : 05/26/2026

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Directions to “ THOMAS DEAN HERLEVICH MD” Practice Location

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