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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134474711 NPPES
Tennessee MEDICAID Q037312
Tennessee MEDICAID 02884332

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