Basic Information
Provider Information
NPI: 1689897159
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ELAHI
FirstName: HAFIZ
MiddleName: AWAIS
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1885
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381011885
CountryCode: US
TelephoneNumber: 9012613500
FaxNumber: 9017258936
Practice Location
Address1: 8000 CENTERVIEW PKWY STE 305
Address2:  
City: CORDOVA
State: TN
PostalCode: 380184225
CountryCode: US
TelephoneNumber: 9012613500
FaxNumber: 9017258936
Other Information
ProviderEnumerationDate: 04/11/2007
LastUpdateDate: 01/29/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/29/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400X42117TNY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

No ID Information.


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