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Individual

DR. RAVI K MADASU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1265 UNION AVE, MEMPHIS, TN 38104-3415
(901) 681-9895
(901) 377-3633
Mailing address
PO BOX 40921, MEMPHIS, TN 38174-0921
(901) 681-9895
(901) 377-3633

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
36543
TN
207R00000X
Internal Medicine Physician
Primary
36543
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3876048
TN
Enumeration date
08/02/2005
Last updated
02/19/2008
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