Basic Information
Provider Information
NPI: 1427578608
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MINHAS
FirstName: SHEHARYAR
MiddleName: SOHAIL
NamePrefix: DR.
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: 7601 SOUTHCREST PKWY
Address2:  
City: SOUTHAVEN
State: MS
PostalCode: 386714739
CountryCode: US
TelephoneNumber: 6627722980
FaxNumber: 6627722960
Other Information
ProviderEnumerationDate: 06/20/2017
LastUpdateDate: 03/29/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/29/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XE-13432ARN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000X61585TNN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000X27841MSY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


Home