Provider Demographics
NPI:1073683728
Name:NADEL, ALAN MARC (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:MARC
Last Name:NADEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:6005 PARK AVENUE
Mailing Address - Street 2:STE 804
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119
Mailing Address - Country:US
Mailing Address - Phone:901-680-9377
Mailing Address - Fax:901-680-9605
Practice Address - Street 1:6005 PARK AVENUE
Practice Address - Street 2:STE 804
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119
Practice Address - Country:US
Practice Address - Phone:901-680-9377
Practice Address - Fax:901-680-9605
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD95102084N0600X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR106800001Medicaid
B03300Medicare UPIN