MARIAM M SULLIVAN (NPI# 1184980872) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184980872 |
| Entity Type | Individual |
| Full Name | MARIAM M SULLIVAN |
| Credential | MD |
| Practice Address |
7691 Poplar Ave Germantown TN 38138-3904 |
| Mailing Address |
P O Box 1000 Dept 351 Memphis TN 38148-0001 |
| Practice Telephone | 9015161290 |
| Practice Fax Number | 9015161220 |
| Mailing Telephone | 9015161290 |
| Mailing Fax Number | 9015161220 |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2019-06-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 52658 | TN | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | 52658 | TN | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7691 Poplar Ave, Germantown, TN 381383904 | 9015161290 | 9015161220 |
| Street Address |
7691 POPLAR AVE |
| City | GERMANTOWN |
| State | TN |
| Zip Code | 38138-3904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700886926 | Robert Neal Rayder | Emergency Medicine | 7691 Poplar Ave, Attn: Emergency Room, Germantown, TN 38138-3904 | 2005-07-29 |
| 1104435148 | Jeannette Marie Gomez | Nurse Practitioner | 7691 Poplar Ave, Germantown, TN 38138-3904 | 2020-07-27 |
| 1710505391 | Joseph Brock Shemwell | Registered Nurse | 7691 Poplar Ave, Germantown, TN 38138-3904 | 2020-07-09 |
| 1972129609 | Bonnie Elizabeth Ellzey | Registered Nurse | 7691 Poplar Ave, Germantown, TN 38138-3904 | 2020-06-18 |
| 1164056693 | Tatyana Dromova Pasley | Nurse Practitioner | 7691 Poplar Ave, Germantown, TN 38138-3904 | 2020-02-24 |
| 1255896957 | Hilary Kabel | Nurse Practitioner | 7691 Poplar Ave, Germantown, TN 38138-3904 | 2019-02-06 |
| 1194205823 | Kimala Moseby-fowler | Nurse Practitioner | 7691 Poplar Ave, Germantown, TN 38138 | 2018-08-21 |
| 1467950105 | Tunja Rash | Nurse Practitioner | 7691 Poplar Ave, Germantown, TN 38138-3904 | 2018-01-29 |
| 1952822843 | Christie Lynn Ragan | Specialist/Technologist, Other | 7691 Poplar Ave, Germantown, TN 38138-3904 | 2017-06-29 |
| 1972023943 | Thomas Clay Carruth | Nurse Practitioner | 7691 Poplar Ave, Germantown, TN 38138-3904 | 2017-06-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790382281 | Bluff Medical Group | Nurse Practitioner | 1779 Kirby Parkway, Suite 1-212, Germantown, TN 38138 | 2020-10-07 |
| 1689293797 | Diana Bryn Manning | Dietitian, Registered | 7705 Poplar Ave., Medical Office B, Suite 150, Germantown, TN 38138 | 2020-04-09 |
| 1386102796 | Moscow Group LLC | Pharmacy | 2013 Exeter Rd, Germantown, TN 38138 | 2019-03-05 |
| 1952811010 | Select | Counselor | 9045 Forest Centre Dr Ste 102, Germantown, TN 38138 | 2017-10-03 |
| 1033638994 | 901 Physical Therapy, Pllc | Physical Therapist | 2495 Regents Walk, Germantown, TN 38138 | 2017-09-12 |
| 1124552401 | Elite Dental Germantown Plc | Dentist | 9064 Corporate Gradens Drive, Germantown, TN 38138 | 2017-04-13 |
| 1740728880 | Christian C Haynes | Nurse Anesthetist, Certified Registered | 1900 Exeter Rd., Suite 210, Germantown, TN 38138 | 2017-02-09 |
| 1740644004 | Kimberly Brooke Scheidegger | Counselor | 9045 Forest Centre Way, Heartlife Professional Soul Care, Germantown, TN 38138 | 2016-04-12 |
| 1427411644 | Jimmy Tam Tran | Internal Medicine | 7550 Wolf River Blvd., Ste. 102, Germantown, TN 38138 | 2016-04-04 |
| 1952761876 | Jane Chin Wynn Yeoh | Orthopaedic Surgery | 1400 South Germantown Road, Germantown, TN 38138 | 2016-03-04 |
| Find all providers in zip 38138 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588139653 | Lakhvinder Wadhwa Md LLC | Internal Medicine | 12800 Middlebrook Rd Ste 114, Germantown, MD 20874-5286 | 2018-10-04 |
| 1427411644 | Jimmy Tam Tran | Internal Medicine | 7550 Wolf River Blvd., Ste. 102, Germantown, TN 38138 | 2016-04-04 |
| 1871958512 | Forever Young Health and Wellness, LLC | Internal Medicine | 6655 Poplar Ave Ste 204, Germantown, TN 38138-0643 | 2015-12-23 |
| 1740656818 | Kimberly Willey Freeman | Internal Medicine | 7550 Wolf River Blvd Ste 102, Germantown, TN 38138-1779 | 2015-08-12 |
| 1063848372 | Vatti T Anthony Md PC | Internal Medicine | 4 Executive Park Ct, Germantown, MD 20874-2645 | 2013-09-18 |
| 1609114610 | Barton Jerome Gershen | Internal Medicine | 15120 Plainfield Ln, Germantown, MD 20874-3402 | 2013-01-25 |
| 1033475785 | John Francisco Trujillo | Internal Medicine | 19735 Germantown Rd Ste 190, Germantown, MD 20874 | 2012-04-06 |
| 1144590415 | Robert E Ferris | Internal Medicine | 19735 Germantown Road, Ste 300, Mobile Medical Care, Inc, Germantown, MD 20874 | 2012-01-04 |
| 1427331982 | Vitality Mens Health and Wellness, LLC | Internal Medicine | 6655 Poplar Ave, Suite 204, Germantown, TN 38138-3691 | 2011-09-21 |
| 1467759860 | Germantown Wellness & Preventive Medicine, Pllc | Internal Medicine | 1900 Exeter Rd Ste 100, Germantown, TN 38138-2954 | 2011-02-21 |
| Find all providers in GERMANTOWN | ||||
| City | GERMANTOWN |
| Zip Code | 38138 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.