Individual
DR. ALLEN ARDESTANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
7945 WOLF RIVER BLVD, GERMANTOWN, TN 38138-1762
(901) 683-0055
(901) 685-2969
Mailing address
7714 POPLAR AVE STE 200, GERMANTOWN, TN 38138-3941
(901) 683-0055
(901) 685-2969
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
25955
MS
2085N0700X
Neuroradiology Physician
Primary
57254
TN
2085R0202X
Diagnostic Radiology Physician
25955
MS
2085R0202X
Diagnostic Radiology Physician
57254
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02884332
—
MS
05
—
Q037312
—
TN
Enumeration date
07/19/2012
Last updated
04/03/2019
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