PETROS KONOFAOS (NPI# 1720364367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720364367 |
| Entity Type | Individual |
| Full Name | PETROS KONOFAOS |
| Credential | M.D., PHD |
| Practice Address |
1068 Cresthaven Rd Suite 500 Memphis TN 38119-0800 |
| Mailing Address |
1407 Union Ave Suite 700 Memphis TN 38104-3627 |
| Practice Telephone | 9018668525 |
| Practice Fax Number | 9013022525 |
| Mailing Telephone | 9018668525 |
| Mailing Fax Number | 9013022525 |
| Enumeration Date | 2011-10-27 |
| Last Update Date | 2018-10-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | MD50989 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003180136A | 05 | |
| MO | 1720364367 | 05 | |
| MS | 08231501 | 05 | |
| AL | 177445 | 05 | |
| AR | 204025001 | 05 | |
| TN | Q007443 | 05 |
| Street Address |
1068 CRESTHAVEN RD SUITE 500 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38119-0800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457354599 | Charlotte A Deflumere | Internal Medicine | 1068 Cresthaven Rd, Suite 110, Memphis, TN 38119-0800 | 2005-05-23 |
| 1881193035 | Walid Amin Mohammad | Pharmacist | 1068 Cresthaven Rd, Memphis, TN 38119-0800 | 2018-02-02 |
| 1972059491 | Desiree Shammas | Nurse Anesthetist, Certified Registered | 1068 Cresthaven Rd, Suite 150, Memphis, TN 38119-0800 | 2016-08-26 |
| 1942754635 | Richard Dawson Holloway IIi | Nurse Practitioner | 1068 Cresthaven Rd, Memphis, TN 38119-0800 | 2016-08-10 |
| 1750834123 | Andrea Baker | Nurse Anesthetist, Certified Registered | 1068 Cresthaven Rd, Suite 150, Memphis, TN 38119-0800 | 2016-08-02 |
| 1639522154 | Haleigh Sligar | Nurse Anesthetist, Certified Registered | 1068 Cresthaven Rd, Suite 150, Memphis, TN 38119-0800 | 2016-07-20 |
| 1972952976 | Dar Salud Care Pllc | Pharmacy | 1068 Cresthaven Rd, Suite 300, Memphis, TN 38119-0800 | 2016-06-09 |
| 1417365156 | Veronica Sanders | Registered Nurse | 1068 Cresthaven Rd, Suite 100, Memphis, TN 38119-0800 | 2014-07-25 |
| 1952712796 | For Sight Eye Care, LLC | Optometrist | 1068 Cresthaven Rd, 300, Memphis, TN 38119-0800 | 2014-05-14 |
| 1649681610 | Magen Mcculloch | Nurse Anesthetist, Certified Registered | 1068 Cresthaven Rd, Suite 150, Memphis, TN 38119-0800 | 2014-05-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417469628 | Jojuan Fullwiley | Behavioral Analyst | 6685 Quince Rd Ste 116, Memphis, TN 38119 | 2017-10-27 |
| 1336675297 | Jill Budynas Depriest | Counselor | 5583 Murray Ave Ste 203, Memphis, TN 38119 | 2017-05-11 |
| 1396279220 | Glen Matthew Stamps Jr. | Counselor | 5583 Murray Ave Ste 207, Memphis, TN 38119 | 2017-04-18 |
| 1598117442 | Hazel Aberdeen | Chiropractor | 1911 Memphis Tennessee, Memphis, TN 38119 | 2016-07-04 |
| 1831569060 | E-c-t Non Emergency Medical Transport | Non-emergency Medical Transport (VAN) | 6869 Woodlake Dr, Memphis, TN 38119 | 2015-09-30 |
| 1053781617 | Astrid Roman | Dietitian, Registered | 8020 Hillside Cv, Memphis, MS 38119 | 2015-09-25 |
| 1467857664 | Allan Jacob Katz | Counselor | 5668 Rex Rd, Suite 104, Memphis, TN 38119 | 2014-10-30 |
| 1962836015 | Judy Ann Harrick | Acupuncturist | 5575 Poplar Ave., #702, Memphis, TN 38119 | 2013-08-26 |
| 1366791949 | Jennifer Denyes Bidelman | Audiologist | 5625 Poplar Avenue, Memphis, TN 38119 | 2012-08-29 |
| 1578833620 | Elizabeth Mary Dion-douglass | Pharmacist | 2891 Kirby Parkway, Memphis, TN 38119 | 2012-01-06 |
| Find all providers in zip 38119 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023244357 | Amie Rae Miller | Plastic Surgery | 920 Madison Ave Ste 447, Memphis, TN 38103-3438 | 2009-06-01 |
| 1154578573 | Sylvia Shepherd Strock | Plastic Surgery | 4634 Peppertree Lane, Memphis, TN 38117 | 2008-08-27 |
| 1538326434 | Melissa Anne Kath | Plastic Surgery | 80 Humphreys Center Dr Ste 100, Memphis, TN 38120-2352 | 2008-05-19 |
| 1043316821 | Dan Huff Shell IIi | Plastic Surgery | 6209 Poplar Ave, Suite 200, Memphis, TN 38119-4712 | 2006-09-16 |
| 1164436226 | Robert Louis Adams | Plastic Surgery | 80 Humphreys Ctr Ste 100, Memphis, TN 38120-2352 | 2006-07-27 |
| 1326003179 | Ellis Tavin | Plastic Surgery | 80 Humphreys Center Dr, #100, Memphis, TN 38120 | 2006-04-17 |
| 1033598248 | Steven D Kozusko | Plastic Surgery | 910 Madison Ave, Memphis, TN 38103-3403 | 2015-05-20 |
| 1760823595 | Kalyan Chakravarthy Dadireddy | Plastic Surgery | 1068 Cresthaven Rd Ste 500, Memphis, TN 38119-0846 | 2013-07-09 |
| 1851659981 | Haiqiao Jiao | Plastic Surgery | 1068 Cresthaven Rd Ste 500, Memphis, TN 38119-0846 | 2012-04-26 |
| 1801185228 | Cedric Lawon Hunter | Plastic Surgery | 1068 Cresthaven Rd Ste 500, Memphis, TN 38119-0846 | 2011-04-06 |
| Find all providers in MEMPHIS | ||||
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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.