Provider Demographics
NPI:1639370257
Name:DALAL, APURVA RASHMIKANT (MD)
Entity Type:Individual
Prefix:
First Name:APURVA
Middle Name:RASHMIKANT
Last Name:DALAL
Suffix:
Gender:M
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:PO BOX 38539
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38183-0539
Mailing Address - Country:US
Mailing Address - Phone:901-333-2525
Mailing Address - Fax:901-786-6635
Practice Address - Street 1:7656 POPLAR PIKE
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-5941
Practice Address - Country:US
Practice Address - Phone:901-333-2525
Practice Address - Fax:901-786-6633
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34477207X00000X
MS18808207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3713370Medicaid
MS04089380Medicaid
TN3882304Medicare PIN
G91869Medicare UPIN
TN3713370Medicaid
5384150001Medicare NSC