Basic Information
Provider Information
NPI: 1447926878
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAMI
FirstName: ARSHAWN
MiddleName: N/A
NamePrefix:  
NameSuffix:  
Credential: CAA
OtherOrganizationName:  
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OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1941 OTTER CREEK RD
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372155741
CountryCode: US
TelephoneNumber: 6155221932
FaxNumber:  
Practice Location
Address1: 80 JESSE HILL JR DR SE
Address2:  
City: ATLANTA
State: GA
PostalCode: 303033031
CountryCode: US
TelephoneNumber: 4046161000
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/17/2021
LastUpdateDate: 08/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367H00000X  Y193400000X SINGLE SPECIALTY GROUPPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant 

No ID Information.


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