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Individual

DR. CHARLOTTE A DEFLUMERE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1068 CRESTHAVEN RD, SUITE 110, MEMPHIS, TN 38119-0800
(901) 405-6470
(901) 747-2338
Mailing address
PO BOX 17825, MEMPHIS, TN 38187-0825
(901) 405-6470
(901) 747-2338

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD0000020004
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110214654
RAILROAD MEDICARE
TN
01
3106698
TN BCBS PROVIDER NUMBER
TN
05
3826001
TN
01
4417762
AETNA
TN
05
5007925
TN
01
627127667
TAX ID
TN
Enumeration date
05/23/2005
Last updated
09/11/2012
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