Provider Demographics
NPI:1912919986
Name:PILGRIM, PAULA (MD)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:PILGRIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2028 W POPLAR AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-0618
Mailing Address - Country:US
Mailing Address - Phone:901-755-2900
Mailing Address - Fax:901-755-2975
Practice Address - Street 1:2028 W POPLAR AVE STE 110
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-0618
Practice Address - Country:US
Practice Address - Phone:901-755-2900
Practice Address - Fax:901-755-2975
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD17916207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNF00896Medicare UPIN