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Individual

DR. AMIT MALHOTRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
391 SOUTHCREST CIR, SUITE 200, SOUTHAVEN, MS 38671-6730
(901) 271-1000
(901) 271-4187
Mailing address
8060 WOLF RIVER BLVD, GERMANTOWN, TN 38138-1727
(901) 271-1000
(901) 271-4187

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
36555
TN
207RI0011X
Interventional Cardiology Physician
Primary
19492
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000379332
RAIL ROAD MEDICARE
TN
05
03907881
MS
01
06120013401
QUALCHOICE
01
27550
TLC
TN
05
3892297
TN
01
4146200
BCBS
TN
01
7019599
AETNA
TN
01
84389
BCBS
AR
01
P00372262
RAIL ROAD MEDICARE
MS
Enumeration date
05/09/2006
Last updated
06/12/2025
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