Provider Demographics
NPI:1447341755
Name:MENON, AIYAPPAN (MD)
Entity type:Individual
Prefix:DR
First Name:AIYAPPAN
Middle Name:
Last Name:MENON
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 1:3810 CENTRAL PIKE STE 105
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-3495
Mailing Address - Country:US
Mailing Address - Phone:615-649-6410
Mailing Address - Fax:800-319-2124
Practice Address - Street 1:3810 CENTRAL PIKE STE 105
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-3495
Practice Address - Country:US
Practice Address - Phone:615-649-6410
Practice Address - Fax:800-319-2124
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN56470207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0164843Medicaid
OHME0868923Medicare PIN
OH0164843Medicaid