Provider Demographics
NPI:1407179278
Name:NASROLLAH JAHDI MD INC
Entity Type:Organization
Organization Name:NASROLLAH JAHDI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NASROLLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:JAHDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-266-7900
Mailing Address - Street 1:PO BOX 369
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-0369
Mailing Address - Country:US
Mailing Address - Phone:724-266-7900
Mailing Address - Fax:724-266-4616
Practice Address - Street 1:1 ROSS PARK BLVD
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2681
Practice Address - Country:US
Practice Address - Phone:740-282-9093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD028222E207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV2514638OtherMOUNTAIN STATE BC/BS
PA2498585OtherHIGHMARK BC/BS
OH3052093Medicaid
OH2498595OtherHIGHMARK BC/BS
OH000000653951OtherANTHEM BC/BS
WV3810008146Medicaid
PADR8248OtherRAILROAD MEDICARE
PA1024465780001Medicaid
OHDQ7474OtherRAILROAD MEDICARE
OH3052093Medicaid
WV3810008146Medicaid
WVA184Medicare PIN