Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 60113 | TN |
NPI | 1316387095 |
---|---|
Provider Name | Dr. Nitish Chourasia |
First Address | Memphis, TN 38105-4607 |
Second Address | Memphis, TN 38103-2816 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2013 |
Last Update Date | 28/07/2020 |