Individual
MARAM MALLISHO
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
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01075712A
IN
207R00000X
Internal Medicine Physician
Primary
52977
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q021679
—
TN
Enumeration date
04/28/2012
Last updated
10/15/2025
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