Provider Demographics
NPI:1184611527
Name:SULEIMAN, NASIR M (MD)
Entity type:Individual
Prefix:MR
First Name:NASIR
Middle Name:M
Last Name:SULEIMAN
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 1:2301 S. BROAD STREET
Mailing Address - Street 2:ANESTHESIA DEPARTMENT
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-3594
Mailing Address - Country:US
Mailing Address - Phone:215-300-0424
Mailing Address - Fax:215-952-1246
Practice Address - Street 1:2301 S. BROAD STREET
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-3542
Practice Address - Country:US
Practice Address - Phone:215-952-9323
Practice Address - Fax:215-952-1246
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD417129207R00000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019093400001Medicaid
PA0019093400001Medicaid
PAF80085Medicare UPIN