Provider Demographics
NPI:1265428478
Name:UDDIN, NASIR (MD)
Entity type:Individual
Prefix:
First Name:NASIR
Middle Name:
Last Name:UDDIN
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 1:6 STEPTOE CIR
Mailing Address - Street 2:
Mailing Address - City:ELY
Mailing Address - State:NV
Mailing Address - Zip Code:89301-2500
Mailing Address - Country:US
Mailing Address - Phone:775-289-2424
Mailing Address - Fax:775-289-6423
Practice Address - Street 1:6 STEPTOE CIR
Practice Address - Street 2:
Practice Address - City:ELY
Practice Address - State:NV
Practice Address - Zip Code:89301-2500
Practice Address - Country:US
Practice Address - Phone:775-289-2424
Practice Address - Fax:775-289-6423
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8124207P00000X, 207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV8124OtherSTATE MEDICAL LICENSE
NV002017170Medicaid
NV8124OtherSTATE MEDICAL LICENSE
NV33080Medicare ID - Type Unspecified