Provider Demographics
NPI:1326005398
Name:MEDURI, GIANFRANCO UMBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:GIANFRANCO
Middle Name:UMBERTO
Last Name:MEDURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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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:901-448-7642
Mailing Address - Fax:901-448-8015
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?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN19185207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3039685Medicare ID - Type Unspecified
E07080Medicare UPIN
3039686Medicare ID - Type Unspecified