Provider Demographics
NPI:1821697830
Name:SHENDE, MAYURI PRASHANT (MBBS)
Entity Type:Individual
Prefix:
First Name:MAYURI
Middle Name:PRASHANT
Last Name:SHENDE
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:MAYURI
Other - Middle Name:BHIMRAO
Other - Last Name:WANKHEDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:930 MADISON AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-7401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:930 MADISON AVE FL 5
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-7401
Practice Address - Country:US
Practice Address - Phone:901-448-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program