Provider Demographics
NPI:1972732980
Name:SHASTEEN, NAHRAIN M (OD)
Entity Type:Individual
Prefix:DR
First Name:NAHRAIN
Middle Name:M
Last Name:SHASTEEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5150 CHAPPEL DR
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-7256
Mailing Address - Country:US
Mailing Address - Phone:419-873-7446
Mailing Address - Fax:
Practice Address - Street 1:5150 CHAPPEL DR
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551
Practice Address - Country:US
Practice Address - Phone:419-873-7446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-11
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5895152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist