Organization
BARTLETT- RALEIGH INTERNAL MEDICINE GROUP, P. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HERMINIO B BALDERAMA M.D. (PRESIDENT)
(901) 210-6197
Entity
Organization
Contact information
Practice address
8357 MEMPHIS ARLINGTON RD, BARTLETT, TN 38133-2138
(901) 210-6197
(901) 383-1178
Mailing address
8357 MEMPHIS ARLINGTON RD, BARTLETT, TN 38133-2138
(901) 371-0200
(901) 383-1178
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
N/A
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123821
BLUE CROSS BLUE SHIELD
TN
05
—
3702480
—
TN
Enumeration date
06/09/2006
Last updated
07/23/2021
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