Provider Demographics
NPI:1659397297
Name:NAHAS, FREDERICK JOHN II (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:JOHN
Last Name:NAHAS
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 291
Mailing Address - Street 2:631 SHORE RD.
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-0291
Mailing Address - Country:US
Mailing Address - Phone:609-653-1010
Mailing Address - Fax:609-653-9591
Practice Address - Street 1:631 SHORE RD
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2483
Practice Address - Country:US
Practice Address - Phone:609-653-1010
Practice Address - Fax:609-653-9591
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA03497900208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2992906Medicaid
NJ2992906Medicaid
C53610Medicare UPIN