Provider Demographics
NPI:1417016387
Name:HARROM, HEIDI (MD)
Entity type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:
Last Name:HARROM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3443 DICKERSON PIKE
Mailing Address - Street 2:STE 380
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-2519
Mailing Address - Country:US
Mailing Address - Phone:615-860-2221
Mailing Address - Fax:615-860-9560
Practice Address - Street 1:3443 DICKERSON PIKE
Practice Address - Street 2:STE 380
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-2519
Practice Address - Country:US
Practice Address - Phone:615-860-2221
Practice Address - Fax:615-860-9560
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006010182084N0400X
TN427502084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I269042OtherMEDICARE PTAN
TN4273676OtherBCBS