Provider Demographics
NPI:1922230002
Name:NASSER, EIAD (MD)
Entity Type:Individual
Prefix:
First Name:EIAD
Middle Name:
Last Name:NASSER
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 1:510 UPPER CHESAPEAKE DR
Mailing Address - Street 2:SUITE 416
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4328
Mailing Address - Country:US
Mailing Address - Phone:443-643-4700
Mailing Address - Fax:443-643-4707
Practice Address - Street 1:510 UPPER CHESAPEAKE DR STE 416
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4336
Practice Address - Country:US
Practice Address - Phone:443-643-4700
Practice Address - Fax:443-643-4707
Is Sole Proprietor?:No
Enumeration Date:2009-08-21
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0080685207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS110955004Medicare UPIN