Provider Demographics
NPI:1669447686
Name:BISWAS, AJIT K (MD)
Entity Type:Individual
Prefix:DR
First Name:AJIT
Middle Name:K
Last Name:BISWAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1900 EXETER RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-2954
Mailing Address - Country:US
Mailing Address - Phone:901-818-2162
Mailing Address - Fax:901-818-2163
Practice Address - Street 1:1900 EXETER RD
Practice Address - Street 2:SUITE 210
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-2954
Practice Address - Country:US
Practice Address - Phone:901-818-2162
Practice Address - Fax:901-818-2163
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD9577207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR106880001Medicaid
MO200831519Medicaid
TN3160796Medicaid
MS09289276Medicaid
TN3160796Medicaid
MS09289276Medicaid