Provider Demographics
NPI:1205275914
Name:NAWAZ, NASIR (MD)
Entity type:Individual
Prefix:
First Name:NASIR
Middle Name:
Last Name:NAWAZ
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 CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-3902
Mailing Address - Country:US
Mailing Address - Phone:610-447-2000
Mailing Address - Fax:610-447-6373
Practice Address - Street 1:4645 NW 8TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4687
Practice Address - Country:US
Practice Address - Phone:352-375-1212
Practice Address - Fax:352-371-4650
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT203245390200000X
FLME145044207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program