Provider Demographics
NPI:1891923025
Name:NAZER, EYAD HUSAM (MD)
Entity Type:Individual
Prefix:
First Name:EYAD
Middle Name:HUSAM
Last Name:NAZER
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 1:1 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:SC
Mailing Address - Zip Code:29706-9769
Mailing Address - Country:US
Mailing Address - Phone:803-581-3170
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:SC
Practice Address - Zip Code:29706
Practice Address - Country:US
Practice Address - Phone:803-581-3170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY45116207R00000X
NC180949207R00000X, 208M00000X
SC36245208M00000X
NC2012-01341207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1891923025Medicaid
SC1891923025Medicaid
NC1891923025Medicaid
NCNC7624HMedicare PIN
NCNC7624IMedicare PIN