Provider Demographics
NPI:1467666016
Name:SOHRABI, NADER (DPH)
Entity Type:Individual
Prefix:DR
First Name:NADER
Middle Name:
Last Name:SOHRABI
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 TREETOP LANE
Mailing Address - Street 2:
Mailing Address - City:WARTRACE
Mailing Address - State:TN
Mailing Address - Zip Code:37183
Mailing Address - Country:US
Mailing Address - Phone:931-455-1691
Mailing Address - Fax:
Practice Address - Street 1:909 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-2313
Practice Address - Country:US
Practice Address - Phone:931-455-1423
Practice Address - Fax:931-455-5204
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4485183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist