Individual
DR. MICHELLE L SURBROOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
877 JEFFERSON AVE, MEMPHIS, TN 38103-2807
(901) 545-7100
(901) 545-8996
Mailing address
877 JEFFERSON AVE, ATTN: PROVIDER ENROLLMENT, MEMPHIS, TN 38103-2807
(901) 545-7302
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
28744
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3816954
—
TN
Enumeration date
04/28/2006
Last updated
05/29/2015
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