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Individual

PANRAPEE JESSE MAHAUTMR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6019 WALNUT GROVE RD, MEMPHIS, TN 38120-2113
(901) 226-3610
Mailing address
PO BOX 405827, ATLANTA, GA 30384-5827
(901) 226-3186
(901) 226-3160

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
4301512827
MI
2084P0800X
Psychiatry Physician
Primary
62337
TN
2084P0800X
Psychiatry Physician
82423
GA
2084P0800X
Psychiatry Physician
A171379
CA

Other

Enumeration date
04/30/2016
Last updated
04/17/2025
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