Provider Demographics
NPI:1457536559
Name:TALWAR, MANISH (MBBS)
Entity Type:Individual
Prefix:DR
First Name:MANISH
Middle Name:
Last Name:TALWAR
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P O BOX 1000 DEPT 457
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:901-516-9183
Mailing Address - Fax:901-516-8993
Practice Address - Street 1:1265 UNION AVE STE 184
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3415
Practice Address - Country:US
Practice Address - Phone:901-516-9183
Practice Address - Fax:901-516-8993
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN49618207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS02433843Medicaid
TN6002384OtherBCBS
TN1532159Medicaid
AR198059001Medicaid