Provider Demographics
NPI:1225009384
Name:RAFAT NASHED ORTHOPEDICS, INC
Entity Type:Organization
Organization Name:RAFAT NASHED ORTHOPEDICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAFAT
Authorized Official - Middle Name:
Authorized Official - Last Name:NASHED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-355-6070
Mailing Address - Street 1:PO BOX 1209
Mailing Address - Street 2:
Mailing Address - City:MARYLAND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-0209
Mailing Address - Country:US
Mailing Address - Phone:314-989-0300
Mailing Address - Fax:
Practice Address - Street 1:2865 NETHERTON DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-4674
Practice Address - Country:US
Practice Address - Phone:314-355-6070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-27
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO104163207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207770918Medicaid
MOF25631Medicare UPIN
MO0963270001Medicare NSC
IL635050Medicare PIN
MO000000980Medicare PIN