MEDICARE: MAHMOOD NASIR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0600X	Clinical Neurophysiology Physician	MD039921Y	PA
2	2084N0400X	Neurology Physician	MD039921Y	PA
3	2084P2900X	Pain Medicine (Psychiatry & Neurology) Physician	MD039921Y	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	130008812	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7043863	OTHER	PA	GATEWAY
2	J43863	OTHER		AMERIHEALTH
3	043863	OTHER		KEYSTONE
4	5057095	OTHER	PA	AETNA
5	043863	OTHER	PA	PA BLUE SHIELD
7	205802	OTHER		BLACK LUNG
8	0012780720003	OTHER		PA MEDICAL ASSISTANCE
9	01076501	OTHER		CAPITAL BLUE CROSS
10	232750024	OTHER		TRICARE
11	MD039921Y	OTHER		PA LICENSE

General Provider Information

NPI Number	:	1497738934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAHMOOD NASIR MD

Provider Business Mailing Address
First Line	:	512 MARKET ST
Second Line	:
City	:	SUNBURY
State	:	PA
Zip	:	17801-2338
Country	:	US
Telephone Number	:	570-286-9878
Fax Number	:	570-286-9848

Provider Business Practice Location Address
First Line	:	512 MARKET ST
Second Line	:
City	:	SUNBURY
State	:	PA
Zip	:	17801-2338
Country	:	US
Telephone Number	:	570-286-9878
Fax Number	:	570-286-9848

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2005
Last Update Date	:	10/07/2014

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Directions to “ MAHMOOD NASIR MD” Practice Location

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