Provider Demographics
NPI:1942453949
Name:ASHRAF S NASSEF MD INC
Entity Type:Organization
Organization Name:ASHRAF S NASSEF MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASHRAF
Authorized Official - Middle Name:S
Authorized Official - Last Name:NASSEF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-949-1534
Mailing Address - Street 1:4404 GLEN ESTE WITHAMSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-1306
Mailing Address - Country:US
Mailing Address - Phone:304-949-1534
Mailing Address - Fax:304-949-1534
Practice Address - Street 1:1104 PARIS RD
Practice Address - Street 2:STE 100
Practice Address - City:MAYFIELD
Practice Address - State:KY
Practice Address - Zip Code:42066-3328
Practice Address - Country:US
Practice Address - Phone:270-804-4474
Practice Address - Fax:270-804-4478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY338542084N0400X, 2084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65939993Medicaid
KY00844Medicare PIN
KY65939993Medicaid