| Javed Abdullah, MD | |
|
4250 Bethel Rd, 5th Floor, Olive Branch, MS 38654-8737 | |
| (901) 763-0200 | |
| (901) 761-4002 |
| Full Name | Javed Abdullah |
|---|---|
| Gender | Male |
| Speciality | Interventional Cardiology |
| Experience | 26 Years |
| Location | 4250 Bethel Rd, Olive Branch, Mississippi |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184801367 | NPI | - | NPPES |
| 6041886 | Other | TN | BCBS |
| 06926726 | Medicaid | MS | |
| Q002944 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0011X | Internal Medicine - Interventional Cardiology | 50265 (Tennessee) | Secondary |
| 207RI0011X | Internal Medicine - Interventional Cardiology | 23973 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Methodist Healthcare Memphis Hospitals | Memphis, TN | Hospital |
| Methodist Healthcare - Olive Branch Hospital | Olive branch, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Specialty Physician Group Llc | 9537291323 | 90 |
| Specialty Physician Group Llc | 9537291323 | 90 |
| Entity Name | Specialty Physician Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174842181 PECOS PAC ID: 9537291323 Enrollment ID: O20100714000297 |
| Mailing Address | Practice Location Address |
|---|---|
| Javed Abdullah, MD Po Box 1000, Dept # 960, Memphis, TN 38148-0001 Ph: (901) 763-0200 | Javed Abdullah, MD 4250 Bethel Rd, 5th Floor, Olive Branch, MS 38654-8737 Ph: (901) 763-0200 |
Dr. Ajay Narayan Venkatanarayan, Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 4240 Bethel Rd Ste 201, Olive Branch, MS 38654 Phone: 901-763-0200 Fax: 901-761-4002 | |
Charles H. Fraga, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 4250 Bethel Rd, Olive Branch, MS 38654 Phone: 901-516-1290 Fax: 901-516-1220 | |
Wendy Michelle Ballenger, DO Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 7148 Kerr Street Place, Suite 110, Olive Branch, MS 38654 Phone: 662-222-6724 Fax: 901-350-5024 | |
James Riddell Lewis, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 4250 Bethel Rd, Olive Branch, MS 38654 Phone: 901-516-1290 Fax: 901-516-1220 | |
Sheryl Ingram, Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 3195 Threatt Rd, Olive Branch, MS 38654 Phone: 901-331-2591 | |
Vivian Sze Ting Lo, D.O Internal Medicine Medicare: Medicare Enrolled Practice Location: 4250 Bethel Rd, Olive Branch, MS 38654 Phone: 662-932-9111 |