Provider Demographics
NPI:1710107099
Name:NASIF, MARWAN G (MD)
Entity Type:Individual
Prefix:
First Name:MARWAN
Middle Name:G
Last Name:NASIF
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 1:7879 AUBURN RD STE 1A
Mailing Address - Street 2:
Mailing Address - City:CONCORD TWP
Mailing Address - State:OH
Mailing Address - Zip Code:44077-9611
Mailing Address - Country:US
Mailing Address - Phone:440-354-0944
Mailing Address - Fax:
Practice Address - Street 1:7879 AUBURN RD STE 1A
Practice Address - Street 2:
Practice Address - City:CONCORD TWP
Practice Address - State:OH
Practice Address - Zip Code:44077-9611
Practice Address - Country:US
Practice Address - Phone:440-354-0944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301084374207R00000X
OH35092518207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine