Provider Demographics
NPI:1265432488
Name:RANGASWAMI, NARAYANASWAMI (MD)
Entity type:Individual
Prefix:DR
First Name:NARAYANASWAMI
Middle Name:
Last Name:RANGASWAMI
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 1:877 JEFFERSON AVE
Mailing Address - Street 2:5TH FLOOR ADAMS PAVILION
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-2807
Mailing Address - Country:US
Mailing Address - Phone:901-515-4529
Mailing Address - Fax:901-515-4599
Practice Address - Street 1:1064 BREEDLOVE ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38107-2805
Practice Address - Country:US
Practice Address - Phone:901-515-5400
Practice Address - Fax:901-526-1208
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11404207PP0204X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNB59386Medicare UPIN
TN3896613Medicare ID - Type Unspecified
TN38966131Medicare PIN