Provider Demographics
NPI:1720004187
Name:NABI, NASSER (MD)
Entity Type:Individual
Prefix:
First Name:NASSER
Middle Name:
Last Name:NABI
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 1:100 HIGHLAND ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-3881
Mailing Address - Country:US
Mailing Address - Phone:617-698-2775
Mailing Address - Fax:617-698-2778
Practice Address - Street 1:100 HIGHLAND ST
Practice Address - Street 2:SUITE 107
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-3881
Practice Address - Country:US
Practice Address - Phone:617-698-2775
Practice Address - Fax:617-698-2778
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA033570207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0154121Medicaid
A53785Medicare UPIN
MA0154121Medicaid