Dr. Richard G Wanderman
Family Doctor Allergist Adolescent Medicine
4646 Poplar Ave Ste 302
Memphis
, Tennessee 38117-4433
Dr. Richard G Wanderman
Family Doctor Allergist Adolescent Medicine
4646 Poplar Ave Ste 302
Memphis
, Tennessee 38117-4433
(901) 552-3902
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About
Features
Specialties
- Allergist
- Family Doctor
- Adolescent Medicine
Languages spoken
- English
Location
First Address
- Dr. Richard G Wanderman
- 4646 Poplar Ave Ste 302
- Memphis, TN
- Zip : 38117-4433
- Fax : (901) 552-3902
- Phone : (901) 930-7397
Second Address
- Dr. Richard G Wanderman
- 4646 Poplar Ave Ste 302
- Memphis, TN
- Zip : 38117-4433
- Fax : (905) 552-3902
- Phone : (901) 930-7397
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207KA0200X | Allergist | 22468 | TN |
| Y | 207Q00000X | Family Doctor | 22468 | TN |
| N | 2080A0000X | Adolescent Medicine | 22468 | TN |
National Provider Identifier
| NPI | 1184724312 |
|---|---|
| Provider Name | Dr. Richard G Wanderman |
| First Address | Memphis, TN 38117-4433 |
| Second Address | Memphis, TN 38117-4433 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/09/2006 |
| Last Update Date | 05/02/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 3194814 | (05) | TN |
| B04625 | (02) | TN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.