Provider Demographics
NPI:1790880896
Name:KE, RAYMOND WEEHAN (MD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:WEEHAN
Last Name:KE
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 1:80 HUMPHREYS CTR
Mailing Address - Street 2:SUITE 307
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-2353
Mailing Address - Country:US
Mailing Address - Phone:901-747-2229
Mailing Address - Fax:901-747-4446
Practice Address - Street 1:80 HUMPHREYS CTR
Practice Address - Street 2:SUITE 307
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2353
Practice Address - Country:US
Practice Address - Phone:901-747-2229
Practice Address - Fax:901-747-4446
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD23920207VE0102X
ARR-4393207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1101982OtherCIGNA
TN44990941OtherAETNA
TN4053396OtherBLUE SHIELD
AR96370OtherBLUE SHIELD
3070793Medicare ID - Type UnspecifiedPREVIOUS MEDICARE NUMBER
TN44990941OtherAETNA