Mimily Harsono, MD
Pediatrics, Neonatal-Perinatal Medicine in Memphis, TN. Individual provider (NPI-1).
NPI number1003137571
StatusActive
Last updated in NPPESFeb 25, 2025
Details
- NPI
- 1003137571
- Entity type
- Individual (NPI-1)
- Name
- Mimily Harsono
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 18, 2010
- Certification date
- Feb 25, 2025
- Last updated
- Feb 25, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080N0001X | Pediatrics, Neonatal-Perinatal Medicine | 50025 | TN | Yes |
Practice location
877 Jefferson AveMemphis, TN 38103-2807
Phone 901-545-7100
Mailing address
1068 Cresthaven Rd Ste 300Memphis, TN 38119-0809
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