Fazal M Manejwala, M.D.
Obstetrics & Gynecology in Southaven, MS. Individual provider (NPI-1).
NPI number1730111063
StatusActive
Last updated in NPPESApr 15, 2020
Details
- NPI
- 1730111063
- Entity type
- Individual (NPI-1)
- Name
- Fazal M Manejwala
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 7, 2006
- Certification date
- Apr 15, 2020
- Last updated
- Apr 15, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - OBSTETRICS/GYNECOLOGY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | MD027081 | TN | Yes |
Practice location
7900 Airways Blvd Ste 2Southaven, MS 38671-4113
Phone 901-454-1111
Mailing address
8110 N Brother Blvd Ste 200Bartlett, TN 38133-2760
Phone 901-255-5221 · Fax 901-373-4511
Other practice locations
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