Individual
SHELLY L THANNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1755 KIRBY PKWY, SUITE 330, MEMPHIS, TN 38120
(901) 725-5846
(901) 726-4827
Mailing address
PO BOX 171306, MEMPHIS, TN 38187
(800) 809-2106
(334) 386-2037
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
42916
TN
207L00000X
Anesthesiology Physician
E4356
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
157567001
—
AR
Enumeration date
09/14/2006
Last updated
05/31/2024
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