Individual
PATRICK S KULUBYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6490 MOUNT MORIAH ROAD EXT, SUITE 200, MEMPHIS, TN 38115-3729
(901) 565-0244
(901) 565-0616
Mailing address
6490 MOUNT MORIAH ROAD EXT, SUITE 200, MEMPHIS, TN 38115-3729
(901) 565-0244
(901) 565-0616
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
18029
MS
207RN0300X
Nephrology Physician
Primary
37342
TN
207RN0300X
Nephrology Physician
E3707
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07624752
—
MS
05
—
150991001
—
AR
05
—
29502
—
TN
05
—
3889682
—
TN
01
—
4076411
BLUE CROSS BLUE SHIELD
TN
01
—
5M560
BLUE CROSS BLUE SHIELD
AR
Enumeration date
03/14/2006
Last updated
08/12/2010
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