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Individual

DR. TAMUNOINEMI DISRAEL BOB-MANUEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
8060 WOLF RIVER BLVD, GERMANTOWN, TN 38138-1727
(901) 271-1000
(901) 271-4187
Mailing address
8060 WOLF RIVER BLVD, GERMANTOWN, TN 38138-1727
(901) 271-1000
(901) 271-4187

Taxonomy

Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
64950
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
64950
TN LICENSE
TN
05
Q073784
TN
Enumeration date
04/10/2015
Last updated
08/08/2022
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