Harsono, Mimily

Harsono, Mimily is an individual health care provider with primary practice located at University Of Tennessee (Division Of Neonatology) 853 Jefferson Avenue, Suite-201, Newborn Center, Memphis TN 38103. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as her primary health care specialty. Harsono, Mimily can be contacted via phone (901) 448-5950.

Contact Information

Primary practice address
University Of Tennessee (Division Of Neonatology) 853 Jefferson Avenue, Suite-201, Newborn Center Memphis TN 38103
Phone: (901) 448-5950
Fax: (901) 448-1691
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 50025 Tennessee

Profile Details

NPI number 1003137571
LBN Legal business name Harsono, Mimily
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2010
Last updated Oct 8th, 2018 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003137571 NPPES
Mississippi MEDICAID 02507295
Mississippi MEDICAID 1003137571
Mississippi MEDICAID 177423
Mississippi MEDICAID 197560001
Mississippi MEDICAID 00179412A
Mississippi MEDICAID 1532008
Mississippi MEDICAID 1003137571

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