Provider Demographics
NPI:1538503719
Name:NAHUM, ARI L (MD)
Entity Type:Individual
Prefix:DR
First Name:ARI
Middle Name:L
Last Name:NAHUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ARI
Other - Middle Name:
Other - Last Name:HOLLOWAY-NAHUM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:8170 33RD AVE
Mailing Address - Street 2:MS 21110Q
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:640 JACKSON ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101
Practice Address - Country:US
Practice Address - Phone:651-254-3456
Practice Address - Fax:651-254-9673
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN60230207R00000X
WI69932-20207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine