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Individual

GENTI TAHIRAJ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
830 S GLOSTER ST, TUPELO, MS 38801-4934
(615) 477-8401
Mailing address
830 S GLOSTER ST, TUPELO, MS 38801-4934
(615) 477-8401

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
21507
MS

Other

Enumeration date
06/24/2008
Last updated
01/26/2013
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