Provider Demographics
NPI:1538253570
Name:NARUMANCHI, TARACHANDRA M (MD)
Entity type:Individual
Prefix:DR
First Name:TARACHANDRA
Middle Name:M
Last Name:NARUMANCHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:571 WILD ELM CV
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-2541
Mailing Address - Country:US
Mailing Address - Phone:042-615-6695
Mailing Address - Fax:
Practice Address - Street 1:571 WILD ELM CV
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2541
Practice Address - Country:US
Practice Address - Phone:042-615-6695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2025-0564207SG0201X, 207SG0202X
TN66381207SG0201X
IN01091470A207SG0202X
WI3424-320207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No207SG0202XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Biochemical Genetics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1061778Medicaid
WV3810021861Medicaid
WV0711AMedicare PIN
WV3810021861Medicaid