Provider Demographics
NPI:1164488078
Name:ACCHIARDO, SERGIO R (MD)
Entity Type:Individual
Prefix:DR
First Name:SERGIO
Middle Name:R
Last Name:ACCHIARDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:66 N PAULINE ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38105-5105
Mailing Address - Country:US
Mailing Address - Phone:901-448-2869
Mailing Address - Fax:901-448-1772
Practice Address - Street 1:1910 NONCONNAH BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38132-2113
Practice Address - Country:US
Practice Address - Phone:901-448-2300
Practice Address - Fax:901-448-6657
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2007-08-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN7266207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2005285OtherBC/BS TENNESSEE
TN3155093Medicaid
TN3155093Medicaid
TNB59254Medicare UPIN