MEDICARE: MARINA ABRAHAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	5071	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316696370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARINA ABRAHAM

Provider Business Mailing Address
First Line	:	3320 PERIMETER HILL DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-4123
Country	:	US
Telephone Number	:	615-866-9040
Fax Number	:	615-750-5756

Provider Business Practice Location Address
First Line	:	3320 PERIMETER HILL DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-4123
Country	:	US
Telephone Number	:	615-866-9040
Fax Number	:	615-750-5756

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2022
Last Update Date	:	03/09/2026

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Directions to “ MARINA ABRAHAM ” Practice Location

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