Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | MD039921Y | PA |
N | 2084N0600X | Clinical Neurophysiologist | MD039921Y | PA |
NPI | 1497738934 |
---|---|
Provider Name | Mahmood Nasir |
First Address | Sunbury, PA 17801-2338 |
Second Address | Sunbury, PA 17801-2338 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2005 |
Last Update Date | 07/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0012780720003 | PA MEDICAL ASSISTANCE (01) | |
01076501 | CAPITAL BLUE CROSS (01) | |
043863 | KEYSTONE (01) | |
043863 | PA BLUE SHIELD (01) | PA |
130008812 | RAILROAD MEDICARE (01) | |
205802 | BLACK LUNG (01) | |
232750024 | TRICARE (01) | |
5057095 | AETNA (01) | PA |
7043863 | GATEWAY (01) | PA |
F64520 | (02) | |
J43863 | AMERIHEALTH (01) | |
MD039921Y | PA LICENSE (01) |