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Individual

RAMAKANT MAHADEO MULAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1575 PARR AVE, SUITE B, DYERSBURG, TN 38024-3151
(731) 286-1510
(731) 286-2662
Mailing address
1575 PARR AVE, SUITE B, DYERSBURG, TN 38024-3151
(731) 286-1510
(731) 286-2662

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
109397
MO
207RN0300X
Nephrology Physician
MD017125
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000294177
ANTHEM BCBS OF KY
TN
01
0061459
BLUE CROSS BLUE SHIELD OF
TN
05
117246
TN
05
1504871
TN
01
172300
BLUE CROSS BLUE SHIELD OF
MO
05
202308359
MO
01
392995
HEALTHLINK
TN
01
4602926
AETNA HMO
TN
05
61459
TN
01
621284167
ALL COMMERCIAL INSURANCE
MO
01
621284167
TRICARE SOUTH REGION
TN
05
621284167
TN
05
6312
TN
Enumeration date
08/30/2006
Last updated
11/18/2011
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