Provider Demographics
NPI:1467163543
Name:AM DIABETES CENTERS OF AMERICA PLC
Entity Type:Organization
Organization Name:AM DIABETES CENTERS OF AMERICA PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER/AUTHORIZED OFFICIAL/ M.D
Authorized Official - Prefix:DR
Authorized Official - First Name:KASHIF
Authorized Official - Middle Name:
Authorized Official - Last Name:LATIF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-753-3322
Mailing Address - Street 1:6401 POPLAR AVE STE 604
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-4808
Mailing Address - Country:US
Mailing Address - Phone:901-753-3322
Mailing Address - Fax:901-753-3323
Practice Address - Street 1:6401 POPLAR AVE STE 604
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-4808
Practice Address - Country:US
Practice Address - Phone:901-753-3322
Practice Address - Fax:901-753-3323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-08
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty