Provider Demographics
NPI:1043205362
Name:ARAB, HENGAMEH (PA)
Entity Type:Individual
Prefix:
First Name:HENGAMEH
Middle Name:
Last Name:ARAB
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8078 HIGHWAY 100
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-4212
Mailing Address - Country:US
Mailing Address - Phone:615-942-9810
Mailing Address - Fax:615-942-9827
Practice Address - Street 1:8078 HIGHWAY 100
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-4212
Practice Address - Country:US
Practice Address - Phone:615-942-9810
Practice Address - Fax:615-942-9827
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA1014363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1139135OtherUSA/MCO
TN1517843Medicaid
TN4265869OtherBCBS
TN4265869OtherBCBS