Provider Demographics
NPI:1326012576
Name:BHATTI, NASIR ALAM (MD)
Entity Type:Individual
Prefix:
First Name:NASIR
Middle Name:ALAM
Last Name:BHATTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:40 WILLARD STREET
Mailing Address - Street 2:SUITE 103
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-1252
Mailing Address - Country:US
Mailing Address - Phone:617-471-0011
Mailing Address - Fax:617-481-1284
Practice Address - Street 1:40 WILLARD STREET
Practice Address - Street 2:SUITE 103
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-1252
Practice Address - Country:US
Practice Address - Phone:617-471-0011
Practice Address - Fax:617-481-1284
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA215383207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA215383OtherTUFTS HEALTH PLAN
MA2009633Medicaid
MAJ25649OtherBCBS MA
MAA35019Medicare ID - Type Unspecified
MAJ25649OtherBCBS MA