Provider Demographics
NPI:1083643845
Name:PALLERA, ARNEL M (MD)
Entity Type:Individual
Prefix:
First Name:ARNEL
Middle Name:M
Last Name:PALLERA
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 1:7714 POPLAR AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3941
Mailing Address - Country:US
Mailing Address - Phone:901-683-0055
Mailing Address - Fax:901-685-2969
Practice Address - Street 1:7945 WOLF RIVER BLVD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1762
Practice Address - Country:US
Practice Address - Phone:901-683-0055
Practice Address - Fax:901-685-2969
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS17759207RH0003X
ARE3978207RH0003X
TN30872207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
7847313OtherAETNA
MO148162001Medicaid
AR148162001Medicaid
TN308420934OtherAHS
AR99247OtherBCBS AR
TN3870763Medicaid
MS00126935Medicaid
TN4039127OtherBCBS TN
AR99247OtherBCBS AR
AR148162001Medicaid
TN110236398Medicare PIN
H61736Medicare UPIN
MS00126935Medicaid