| Office Of Internal Medicine, Pc | |
|
2693 Union Avenue Ext Ste 100 Memphis TN 38112-4403 | |
| (901) 726-0843 | |
| (901) 708-2699 |
| Full Name | Office Of Internal Medicine, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2693 Union Avenue Ext Ste 100, Memphis, Tennessee |
| Authorized Official Name and Position | Hany Habashy (OWNER) |
| Authorized Official Contact | 9017260843 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Office Of Internal Medicine, Pc Po Box 1000 Dept 941 Memphis TN 38148-0941 Ph: (901) 726-0843 | Office Of Internal Medicine, Pc 2693 Union Avenue Ext Ste 100 Memphis TN 38112-4403 Ph: (901) 726-0843 |
| NPI Number | 1679776678 |
|---|---|
| Provider Enumeration Date | 06/07/2007 |
| Last Update Date | 05/10/2023 |
| Medicare PECOS PAC ID | 5193860385 |
|---|---|
| Medicare Enrollment ID | O20100226000157 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679776678 | NPI | - | NPPES |
| 3377165 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD0000026072 (Tennessee) | Primary |
| Provider Name | Kimberly D Polk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730411059 PECOS PAC ID: 7719017524 Enrollment ID: I20100604000510 |
| Provider Name | Hany M Habashy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285632224 PECOS PAC ID: 6901941194 Enrollment ID: I20100914000796 |
| Provider Name | Catherine G Phelps |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043618945 PECOS PAC ID: 2668799073 Enrollment ID: I20150324001381 |
| Provider Name | Megan Self |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881143360 PECOS PAC ID: 2466740899 Enrollment ID: I20161018000302 |
| Provider Name | Bridget Lashundra Hopson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477005429 PECOS PAC ID: 8022391770 Enrollment ID: I20170203001516 |
| Provider Name | Gabrielle M Victor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205376712 PECOS PAC ID: 4385920941 Enrollment ID: I20170413001534 |
| Provider Name | Melinda Johnson Williamson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851815542 PECOS PAC ID: 2365798535 Enrollment ID: I20180629001726 |
| Provider Name | Teaire Lashase Carmichael |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699323410 PECOS PAC ID: 6406288984 Enrollment ID: I20191121002334 |
| Provider Name | Mandy Kay Almond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598350746 PECOS PAC ID: 1052713401 Enrollment ID: I20210708001028 |
| Provider Name | Sarah Gano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578138723 PECOS PAC ID: 8628458841 Enrollment ID: I20220706002397 |
| Provider Name | Natalie N Nichols-buerkle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295468783 PECOS PAC ID: 3678932779 Enrollment ID: I20230707001798 |
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