| Dermatology Realm And Family Practice | |
|
2120 Merchants Row Ste 2 Germantown TN 38138-0806 | |
| (901) 362-7170 | |
| (901) 365-9712 |
| Full Name | Dermatology Realm And Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 2120 Merchants Row Ste 2, Germantown, Tennessee |
| Authorized Official Name and Position | Adam W. Baker (MEMBER) |
| Authorized Official Contact | 9013627170 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dermatology Realm And Family Practice 2120 Merchants Row Ste 2 Germantown TN 38138-0806 Ph: (901) 362-7170 | Dermatology Realm And Family Practice 2120 Merchants Row Ste 2 Germantown TN 38138-0806 Ph: (901) 362-7170 |
| NPI Number | 1457751489 |
|---|---|
| Provider Enumeration Date | 08/27/2014 |
| Last Update Date | 08/27/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457751489 | NPI | - | NPPES |
| MD36947 | Other | TN | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD36947 (Tennessee) | Primary |
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