Provider Demographics
NPI:1669531034
Name:NASR, WAEL I (MD)
Entity type:Individual
Prefix:
First Name:WAEL
Middle Name:I
Last Name:NASR
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 1:333 RICCIUTI DR
Mailing Address - Street 2:APT. # 1203
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-6287
Mailing Address - Country:US
Mailing Address - Phone:617-638-8442
Mailing Address - Fax:
Practice Address - Street 1:BOSTON MEDICAL CENTER
Practice Address - Street 2:ONE BOSTON MEDICAL CENTER PALCE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-638-8442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA230635208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery