Basic Information
Provider Information
NPI: 1053303750
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MINHAS
FirstName: SOHAIL
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 965 RIDGE LAKE BLVD STE 103
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381209446
CountryCode: US
TelephoneNumber:  
FaxNumber: 9012278591
Practice Location
Address1: 7900 AIRWAYS BLVD STE 100
Address2:  
City: SOUTHAVEN
State: MS
PostalCode: 386714113
CountryCode: US
TelephoneNumber: 6623492442
FaxNumber: 6623498551
Other Information
ProviderEnumerationDate: 08/18/2005
LastUpdateDate: 06/22/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/22/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003XE1105ARN Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
207RH0003X29661TNN Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
207RH0003X16334MSY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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