Provider Demographics
NPI:1760207922
Name:DAHLHAUSER, PAUL A (MS)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:A
Last Name:DAHLHAUSER
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4711 TROUSDALE DR STE 209
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37220-1380
Mailing Address - Country:US
Mailing Address - Phone:615-781-0709
Mailing Address - Fax:
Practice Address - Street 1:4711 TROUSDALE DR STE 209
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37220-1380
Practice Address - Country:US
Practice Address - Phone:615-781-0709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18920170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0202182Medicaid
TN13121670Medicaid
TN001843475501Medicaid