| Midsouth Internists, Pc | |
|
6025 Walnut Grove Rd Suite 405 Memphis TN 38120-2131 | |
| (901) 537-1892 | |
| (901) 537-1898 |
| Full Name | Midsouth Internists, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6025 Walnut Grove Rd, Memphis, Tennessee |
| Authorized Official Name and Position | Ashutosh Mishra (PRESIDENT) |
| Authorized Official Contact | 9015371892 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midsouth Internists, Pc Po Box 1000 Dept 282 Memphis TN 38148-0001 Ph: (901) 537-1892 | Midsouth Internists, Pc 6025 Walnut Grove Rd Suite 405 Memphis TN 38120-2131 Ph: (901) 537-1892 |
| NPI Number | 1083777015 |
|---|---|
| Provider Enumeration Date | 12/19/2006 |
| Last Update Date | 08/20/2013 |
| Medicare PECOS PAC ID | 0648377218 |
|---|---|
| Medicare Enrollment ID | O20090501000482 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083777015 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 18404 (Mississippi) | Primary |
| Provider Name | Ashutosh Kumar Mishra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942262829 PECOS PAC ID: 6204729353 Enrollment ID: I20040909000085 |
| Provider Name | Debendra N Pattanaik |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1447222880 PECOS PAC ID: 2062496904 Enrollment ID: I20080514000752 |
| Provider Name | Pushpanshu Pushpanshu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477642817 PECOS PAC ID: 1153587514 Enrollment ID: I20140402001769 |
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