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NPI Code Detail

MEDICARE: JAWED NASIM M.D.

MEDICARE: JAWED NASIM M.D.
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
1207RI0200XInfectious Disease Physician35287KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871576702
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAWED NASIM M.D.
Provider Business Mailing Address
First Line : PO BOX 890853
Second Line :
City : CHARLOTTE
State : NC
Zip : 28289-0853
Country : US
Telephone Number : 800-605-5176
Fax Number : 937-298-5596
Provider Business Practice Location Address
First Line : 4001 DUTCHMANS LN
Second Line :
City : LOUISVILLE
State : KY
Zip : 40207-4714
Country : US
Telephone Number : 502-380-5505
Fax Number : 502-426-8272
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2005
Last Update Date : 01/28/2016

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