MEDICARE: DR. VEENA MOHAN 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
1	207R00000X	Internal Medicine Physician	39021	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

General Provider Information

NPI Number	:	1942201710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VEENA MOHAN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 172327
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38187-2327
Country	:	US
Telephone Number	:	901-767-1100
Fax Number	:	901-761-9703

Provider Business Practice Location Address
First Line	:	4066 SUMMER AVE STE. 102
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38122
Country	:	US
Telephone Number	:	901-767-1100
Fax Number	:	901-682-3192

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

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	12/06/2023

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