Organization
DEEPIKA R PULUSANI, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEEPIKA R PULISANI MD (OWNER)
(901) 767-0493
Entity
Organization
Contact information
Practice address
6005 PARK AVE, SUITE 511, MEMPHIS, TN 38119-5202
(901) 767-0493
(901) 767-0414
Mailing address
6005 PARK AVE, SUITE 511, MEMPHIS, TN 38119-5202
(901) 767-0493
(901) 767-0414
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD028857
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306937438
NPI
TN
05
—
3808281
—
TN
Enumeration date
10/29/2007
Last updated
10/29/2007
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