Provider Demographics
NPI:1760684872
Name:NASIR, OMER SALAH (MD)
Entity Type:Individual
Prefix:
First Name:OMER
Middle Name:SALAH
Last Name:NASIR
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 1:204 E CHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:RIDLEY PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19078-1730
Mailing Address - Country:US
Mailing Address - Phone:610-521-4833
Mailing Address - Fax:610-521-2651
Practice Address - Street 1:204 E CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:RIDLEY PARK
Practice Address - State:PA
Practice Address - Zip Code:19078-1730
Practice Address - Country:US
Practice Address - Phone:610-521-4833
Practice Address - Fax:610-521-2651
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22091208600000X
PAMD448450208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery