Individual
GHALIB MANNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6029 WALNUT GROVE RD STE 209, MEMPHIS, TN 38120-2112
(901) 681-0778
(901) 821-9987
Mailing address
6029 WALNUT GROVE RD STE 209, MEMPHIS, TN 38120-2112
(901) 681-0778
(901) 821-9987
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
17199
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000124232
—
MS
05
—
3865813
—
TN
05
—
3865814
—
TN
Enumeration date
05/24/2006
Last updated
01/24/2023
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