Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 01056801A | IN |
N | 207RI0011X | Interventional Cardiology | 01056801A | IN |
NPI | 1063436582 |
---|---|
Provider Name | Naseer H Nasser |
First Address | South Bend, IN 46617-2808 |
Second Address | South Bend, IN 46617-2808 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 08/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
146470D9 | MEDICARE (01) | IN |
200872330 | (05) | IN |
I51378 | (02) | IN |