Provider Demographics
NPI:1508027459
Name:PALAKURTHI, PREETI (MD)
Entity Type:Individual
Prefix:DR
First Name:PREETI
Middle Name:
Last Name:PALAKURTHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PREETI
Other - Middle Name:
Other - Last Name:SHARMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2860 COVINGTON PIKE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-8090
Mailing Address - Country:US
Mailing Address - Phone:901-252-6034
Mailing Address - Fax:901-252-6048
Practice Address - Street 1:2860 COVINGTON PIKE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-8090
Practice Address - Country:US
Practice Address - Phone:901-252-6034
Practice Address - Fax:901-252-6048
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN489432080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1530556Medicaid
TN1530556Medicaid