Dr. Richard G Wanderman
MD | Pediatric Adolescent Medicine | Male
Dr. Richard G Wanderman, MD is a Memphis, Tennessee based Pediatric doctor with medical specialization in
Pediatric Adolescent Medicine.
Current practice location of Dr. Richard G Wanderman is
4646 Poplar Ave Ste 302, Memphis, Tennessee - 38117-4433. He can be contacted on phone at
901-930-7397 and fax number 905-552-3902.
Dr. Richard G Wanderman is a sole proprietor of his business.
NPI number (Unique professional ID) for Dr. Richard G Wanderman is
1184724312 which was assigned by NPPES on 25 Sep, 2006 and it was last updated on 19 Oct, 2022.
Dr. Richard G Wanderman license number is
22468 for Pediatrics, Adolescent Medicine (2080A0000X) in Tennessee.
Dr. Richard G Wanderman specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Dr. Richard G Wanderman basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics, Adolescent Medicine |
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| Provider Name : | Dr. Richard G Wanderman |
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| Credential : | MD |
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| Gender : | Male |
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| Sole Proprietor : | Yes |
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Business Address:
Dr. Richard G Wanderman address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 4646 Poplar Ave Ste 302
Memphis, TN, 38117-4433
United States |
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| Phone Number : | 901-930-7397 |
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| Fax Number : | 905-552-3902 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1184724312 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 25 Sep, 2006 |
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| Last Updated On : | 19 Oct, 2022 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Richard G Wanderman are as mentioned. Primary taxonomy code for Dr. Richard G Wanderman, MD is
2080A0000X (Pediatrics, Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 207KA0200X | Allergy & Immunology, Allergy | No | 22468 | TN |
| 207Q00000X | Family Medicine | No | 22468 | TN |
| 2080A0000X | Pediatrics, Adolescent Medicine | Yes | 22468 | TN |
Legacy Identifiers:
Other legacy medical identifiers of Dr. Richard G Wanderman such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 3194814 | MEDICAID | TN | |
| B04625 | MEDICARE UPIN | TN | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 4646 Poplar Ave Ste 302
Memphis, TN, 38117-4433
United States |
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| Phone Number : | 901-930-7397 |
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| Fax Number : | 901-552-3902 |
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Business Location:
Patients can refer following map for directions to
Dr. Richard G Wanderman practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.