Individual
AMY ELEANORA MAURITSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7691 POPLAR AVE, GERMANTOWN, TN 38138-3904
(901) 516-1290
(901) 516-1220
Mailing address
1211 UNION AVE STE 330, MEMPHIS, TN 38104-6655
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
49495
TN
208M00000X
Hospitalist Physician
49495
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05408516
—
MS
05
—
199592001
—
AR
01
—
4356030
BCBS
TN
01
—
P01277319
RAILROAD MEDICARE
TN
05
—
Q004417
—
TN
Enumeration date
04/22/2010
Last updated
04/23/2025
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