Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 5285 | MD |
N | 1223P0700X | Prosthodontist | 5285 | MD |
NPI | 1164624904 |
---|---|
Provider Name | Mahmoud Foad Nasr |
First Address | Hyattsville, MD 20782-3845 |
Second Address | Hyattsville, MD 20782-3845 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2007 |
Last Update Date | 08/07/2007 |