SUPARNA MULLICK (NPI# 1366547713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366547713 |
| Entity Type | Individual |
| Full Name | SUPARNA MULLICK |
| Credential | MD |
| Practice Address |
9760 Lipsey Cv Germantown TN 38139-8076 |
| Practice Telephone | 9012773534 |
| Practice Fax Number | 9017579065 |
| Mailing Telephone | 9012773534 |
| Mailing Fax Number | 9017579065 |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2017-03-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 49897 | TN | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 2006013531 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 200382901 | 05 |
| Street Address |
9760 LIPSEY CV |
| City | GERMANTOWN |
| State | TN |
| Zip Code | 38139-8076 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154862217 | Mullick Dermatology, Pllc | Dermatology | 9760 Lipsey Cv, Germantown, TN 38139-8076 | 2017-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215582598 | Nutrition Wellness | Nutritionist | 9494 Fox Hill Circle N., Germantown, TN 38139 | 2019-08-05 |
| 1083952600 | Christopher Gilbert | Pharmacist | 2835 Kirby Parkway, Memphis, TN 38139 | 2013-01-17 |
| 1750582292 | Amy Louise Thompson | Speech-Language Pathologist | 8591 Sycamore Trail Dr, Germantown, TN 38139 | 2007-05-31 |
| 1881895480 | Gerald W. Bock | Specialist | 8573 Cordes Circle, Germantown, TN 38139 | 2007-05-30 |
| 1215081120 | Jeffrey Ward Frost | Chiropractor | 9947 Wolf River, Suite 105, Germantown, TN 38139 | 2007-01-22 |
| 1720173859 | Mid South Neurology Clinic Pllc | Psychiatry & Neurology | 8584 Cordes Circle, Germantown, TN 38139 | 2006-10-04 |
| 1972614295 | Miguel Pulido | Dentist | 8590 Farmington Blvd, Suite 5, Germantown, TN 38139 | 2006-08-31 |
| 1467092932 | Mshn Enterprises LLC | Home Health Aide | 8584 Cordes Cir, Germantown, TN 38139-3317 | 2020-01-13 |
| 1356624506 | Addiction & Mental Health Services, LLC | Clinic/Center | 8566 Cordes Cir, Memphis, TN 38139-3317 | 2011-09-23 |
| 1952573255 | Otto Bock Healthcare Lp | Durable Medical Equipment & Medical Supplies | 8570 Cordes Cir, Ste 2, Germantown, TN 38139-3317 | 2008-03-26 |
| Find all providers in zip 38139 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902205206 | Affiliated Dermatologists | Dermatology | N96w17035 Division Rd, Suite A, Germantown, WI 53022-6419 | 2014-08-22 |
| 1407952559 | Lynn M Foley | Dermatology | 2195 West Street, Germantown, TN 38138-3830 | 2006-09-16 |
| 1174637433 | Purvisha J Patel | Dermatology | 7658 Poplar Pike, Germantown, TN 38138-5941 | 2006-08-17 |
| 1316955578 | Adam W Baker | Dermatology | 2120 Merchants Row, Suite 2, Germantown, TN 38138 | 2006-08-04 |
| 1154862217 | Mullick Dermatology, Pllc | Dermatology | 9760 Lipsey Cv, Germantown, TN 38139-8076 | 2017-03-09 |
| 1770036337 | Jodie Darlene Holmes | Dermatology | 7658 Poplar Pike, Advanced Dermatology, Germantown, TN 38138-3813 | 2016-08-01 |
| 1093007767 | Matthew Craig Gordon | Dermatology | 7658 Poplar Pike, Germantown, TN 38138 | 2011-05-12 |
| 1275832461 | Marianne M Junck | Dermatology | N112w17975 Mequon Rd, Germantown, WI 53022-2425 | 2011-03-28 |
| 1184850992 | Brendan Brian Louis Pillemer | Dermatology | 19735 Germantown Rd, Suite 210, Germantown, MD 20874-1214 | 2009-06-08 |
| 1588808562 | Amanda Nicole Cooper | Dermatology | N112w15415 Mequon Rd, Germantown, WI 53022-3410 | 2009-04-22 |
| Find all providers in GERMANTOWN | ||||
| City | GERMANTOWN |
| Zip Code | 38139 |
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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.