| Metropolitan Cardiovascular Institute | |
|
1975 Nonconnah Blvd Memphis TN 38132-2108 | |
| (901) 337-1625 | |
| Not Available |
| Full Name | Metropolitan Cardiovascular Institute |
|---|---|
| Speciality | Internal Medicine |
| Location | 1975 Nonconnah Blvd, Memphis, Tennessee |
| Authorized Official Name and Position | Dwight Anthony Dishmon (OWNER) |
| Authorized Official Contact | 9015964096 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Metropolitan Cardiovascular Institute 2386 Carters Grove Ln Germantown TN 38138-4904 Ph: (901) 596-4096 | Metropolitan Cardiovascular Institute 1975 Nonconnah Blvd Memphis TN 38132-2108 Ph: (901) 337-1625 |
| NPI Number | 1336816388 |
|---|---|
| Provider Enumeration Date | 08/26/2021 |
| Last Update Date | 07/28/2022 |
| Medicare PECOS PAC ID | 2769879352 |
|---|---|
| Medicare Enrollment ID | O20220429000308 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336816388 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 207RI0011X | Internal Medicine - Interventional Cardiology | (* (Not Available)) | Primary |
| Provider Name | Dwight Anthony Dishmon |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1316904048 PECOS PAC ID: 9931165941 Enrollment ID: I20041201001010 |
| Provider Name | Kajuandria Beasley-williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407240732 PECOS PAC ID: 3375857642 Enrollment ID: I20150730011879 |
| Provider Name | Jayna Kelly |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1700229515 PECOS PAC ID: 9931349495 Enrollment ID: I20230407001121 |
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