| Crescent Medical Inc. | |
|
1264 Wesley Dr Suite 501 Memphis TN 38116 | |
| (901) 346-1800 | |
| (901) 346-0043 |
| Full Name | Crescent Medical Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1264 Wesley Dr, Memphis, Tennessee |
| Authorized Official Name and Position | Ahsan H Kathawala (PRESIDENT) |
| Authorized Official Contact | 9013461800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crescent Medical Inc. 1264 Wesley Dr Suite 501 Memphis TN 38116 Ph: (901) 346-1800 | Crescent Medical Inc. 1264 Wesley Dr Suite 501 Memphis TN 38116 Ph: (901) 346-1800 |
| NPI Number | 1295926590 |
|---|---|
| Provider Enumeration Date | 08/05/2007 |
| Last Update Date | 09/21/2007 |
| Medicare PECOS PAC ID | 8123044989 |
|---|---|
| Medicare Enrollment ID | O20051020000681 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295926590 | NPI | - | NPPES |
| 000000115782 | Other | UNISON HEALTH PLAN | |
| 5009811 | Other | MEMPHIS MANAGED CARE | |
| 110235971 | Other | RAILROAD MEDICARE | |
| 3027560 | Other | TN | AETNA |
| 607266900 | Other | ACS | |
| 140096001 | Medicaid | AR | |
| 4028944 | Other | TN | BLUE CROSS BLUE SHEILD |
| 8394237 | Other | TN | CIGNA |
| 3804749 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD0000028245 (Tennessee) | Primary |
| Provider Name | Arifa Kathawala |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1396760617 PECOS PAC ID: 3173624830 Enrollment ID: I20070724000822 |
| Provider Name | Ahsan H Kathawala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962453225 PECOS PAC ID: 1759307523 Enrollment ID: I20110202000070 |
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