Provider Demographics
NPI:1679534473
Name:LIMAN, ANDREW DEDE (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:DEDE
Last Name:LIMAN
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 1:1331 UNION AVE
Mailing Address - Street 2:SUITE 800
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-3513
Mailing Address - Country:US
Mailing Address - Phone:901-725-1785
Mailing Address - Fax:901-725-5264
Practice Address - Street 1:1331 UNION AVE
Practice Address - Street 2:SUITE 800
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3513
Practice Address - Country:US
Practice Address - Phone:901-725-1785
Practice Address - Fax:901-725-5264
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN40102207RH0003X
MS19095207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0530952OtherCIGNA
TN3332340Medicaid
TN35472Medicaid
AR83468OtherBCBS
TN4110264OtherBCBS
MS02206284Medicaid
MS48807380OtherBCBS
TN171117Medicaid
7082127OtherAETNA
H23083Medicare UPIN
MS02206284Medicaid