Organization
DIVERSIFIED HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHREAREST MIGNON CRENSHAW MD (PHYSICIAN)
(901) 684-4646
Entity
Organization
Contact information
Practice address
6005 PARK AVE, SUITE 704, MEMPHIS, TN 38119-5202
(901) 684-4646
(901) 684-4650
Mailing address
6005 PARK AVE, SUITE 704, MEMPHIS, TN 38119-5202
(901) 684-4646
(901) 684-4650
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
39250
TN
Other
Enumeration date
09/20/2011
Last updated
09/20/2011
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