Provider Demographics
NPI:1740271725
Name:NASH, DAVID E (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:NASH
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:PO BOX 8609
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-0036
Mailing Address - Country:US
Mailing Address - Phone:617-573-3635
Mailing Address - Fax:
Practice Address - Street 1:1 MONTVALE AVE
Practice Address - Street 2:SUITE 502
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-3559
Practice Address - Country:US
Practice Address - Phone:781-279-0971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA38672207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2070936Medicaid
MAB30157Medicare ID - Type Unspecified
MAB97033Medicare UPIN