Provider Demographics
NPI:1053386011
Name:NASIR, MOKHTAR N (MD)
Entity type:Individual
Prefix:DR
First Name:MOKHTAR
Middle Name:N
Last Name:NASIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:826 WASHINGTON ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5779
Mailing Address - Country:US
Mailing Address - Phone:410-840-0420
Mailing Address - Fax:410-840-0756
Practice Address - Street 1:826 WASHINGTON ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5779
Practice Address - Country:US
Practice Address - Phone:410-840-0420
Practice Address - Fax:410-840-0756
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2011-09-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MD035711207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD549541500Medicaid
MD155MMedicare ID - Type Unspecified
MD549541500Medicaid