Individual
DR. JIVAN DALSANIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1068 CRESTHAVEN RD, SUITE 150, MEMPHIS, TN 38119-0800
(901) 682-6828
Mailing address
PO BOX 171181, MEMPHIS, TN 38187-1181
(901) 682-2872
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD17381
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00019608
MISSISSIPPI MEDICAID
MS
01
—
050049460
RR MEDICARE
—
01
—
3018829
BLUE CROSS
TN
05
—
3029532
—
TN
Enumeration date
07/08/2006
Last updated
10/26/2016
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