Provider Demographics
NPI:1669636478
Name:NASSER, AZMI (DO)
Entity Type:Individual
Prefix:DR
First Name:AZMI
Middle Name:
Last Name:NASSER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1301 E MCDOWELL RD
Mailing Address - Street 2:STE 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2621
Mailing Address - Country:US
Mailing Address - Phone:602-265-8800
Mailing Address - Fax:602-265-8151
Practice Address - Street 1:1301 E MCDOWELL RD
Practice Address - Street 2:STE 100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2621
Practice Address - Country:US
Practice Address - Phone:602-265-8800
Practice Address - Fax:602-265-8151
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL125051358208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
5299OtherLICENSE
AZ440192OtherAHCCCS
Z130927Medicare PIN