Provider Demographics
NPI:1578628400
Name:NASH, DAVID BRUCE (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:BRUCE
Last Name:NASH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:L- 3513
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:44460-2423
Mailing Address - Country:US
Mailing Address - Phone:330-520-2221
Mailing Address - Fax:330-776-5557
Practice Address - Street 1:1995 E STATE ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-2423
Practice Address - Country:US
Practice Address - Phone:330-332-7320
Practice Address - Fax:330-332-7723
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35043342207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0581035Medicaid
OH0581035Medicaid
OH9290871Medicare ID - Type Unspecified