Ardestani, Allen
Ardestani, Allen is an individual health care provider with primary practice located at 7945 Wolf River Blvd , Germantown TN 38138-1762. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Neuroradiology is his primary health care specialty. Ardestani, Allen can be contacted via phone (901) 683-0055.Contact Information
Primary practice address
7945 Wolf River Blvd
Germantown TN 38138-1762
Phone: (901) 683-0055
Fax: (901) 685-2969
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neuroradiology | 2085N0700X | 25955 | Mississippi |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 57254 | Tennessee |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 25955 | Mississippi |
| Allopathic & Osteopathic Physicians / Neuroradiology | 2085N0700X | 57254 | Tennessee |
Profile Details
| NPI number | 1134474711 |
|---|---|
| LBN Legal business name | Ardestani, Allen |
| Credentials | MD, PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 19th, 2012 |
| Last updated | Apr 3rd, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134474711 | NPPES |
| Tennessee | MEDICAID | Q037312 | |
| Tennessee | MEDICAID | 02884332 |
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