Basic Information
| Provider Information | |||||||||
| NPI: | 1063052868 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAYEGH | ||||||||
| FirstName: | NATHAN | ||||||||
| MiddleName: | ATALLAH | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12267 CREEKWOOD LN | ||||||||
| Address2: | |||||||||
| City: | CARMEL | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460328286 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3176700313 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2001 W 86TH ST | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462601902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3173382345 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2020 | ||||||||
| LastUpdateDate: | 01/22/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 28213673A | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.