Provider Demographics
NPI:1295700110
Name:RAAB, GREGORY ERNEST (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:ERNEST
Last Name:RAAB
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:PO BOX 306076
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6076
Mailing Address - Country:US
Mailing Address - Phone:615-284-2000
Mailing Address - Fax:615-284-2003
Practice Address - Street 1:2021 CHURCH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2021
Practice Address - Country:US
Practice Address - Phone:615-284-2000
Practice Address - Fax:615-284-2003
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41491207X00000X
NC200600137207XS0114X
PAMD423193207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3833904Medicaid
TN7513793OtherAETNA
TNTN01M9OtherUNITED HEALTHCARE
TN4156161OtherBLUECROSS BLUESHIELD
TN6959668OtherCIGNA
TN3833904Medicare PIN
TN3833905Medicare PIN
TN3833904Medicaid