Provider Demographics
NPI:1750398343
Name:NASLUND, MICHAEL J (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:NASLUND
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 64226
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4742
Mailing Address - Country:US
Mailing Address - Phone:410-328-5300
Mailing Address - Fax:410-328-2109
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-5300
Practice Address - Fax:410-328-2109
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD27182208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD17749OtherFREESTATE
MD217009OtherMDIPA
MD479611000Medicaid
MD112716OtherUS HLTHCARE
MD52057503OtherBLUE SHIELD
MD80041OtherGEISINGER
PA1436752/01Medicaid
DE0000483401Medicaid
MD1900358OtherUNITED HLTHCARE
MD214347OtherKAISER
MD0991816OtherUNITED HLTHCARE NATIONAL
MD0022OtherCAREFIRST REGIONAL
MD52057503OtherBLUE SHIELD
PA1436752/01Medicaid
MD479611000Medicaid