Provider Demographics
NPI:1245025915
Name:NODIT, PAUL GABRIEL
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:GABRIEL
Last Name:NODIT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 PASADENA PL APT 140
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-6653
Mailing Address - Country:US
Mailing Address - Phone:865-343-1394
Mailing Address - Fax:
Practice Address - Street 1:215 PASADENA PL APT 140
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-6653
Practice Address - Country:US
Practice Address - Phone:865-343-1394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program