Provider Demographics
NPI:1124406921
Name:MALDONADO, NORA ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:ELIZABETH
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:P O BOX 1000 DEPT 978
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:901-752-2300
Mailing Address - Fax:901-752-2367
Practice Address - Street 1:9047 POPLAR AVE STE 105
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138
Practice Address - Country:US
Practice Address - Phone:901-752-2300
Practice Address - Fax:901-752-2367
Is Sole Proprietor?:No
Enumeration Date:2015-05-12
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN57764207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine