Provider Demographics
NPI:1134138761
Name:BAYMILLER, NILOOFAR MOTAKEF (MD)
Entity Type:Individual
Prefix:DR
First Name:NILOOFAR
Middle Name:MOTAKEF
Last Name:BAYMILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1938 ROWAN LN
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-2564
Mailing Address - Country:US
Mailing Address - Phone:901-755-0208
Mailing Address - Fax:901-861-9793
Practice Address - Street 1:5885 RIDGEWAY CENTER PKWY STE 101
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-4011
Practice Address - Country:US
Practice Address - Phone:901-288-6255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37022207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3330810Medicaid
TN3330810Medicaid
I31912Medicare UPIN