Healthcare Provider Details

I. General information

NPI: 1942453949
Provider Name (Legal Business Name): ASHRAF S NASSEF MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2008
Last Update Date: 06/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1104 PARIS RD STE 100
MAYFIELD KY
42066-3328
US

IV. Provider business mailing address

4404 GLEN ESTE WITHAMSVILLE RD
CINCINNATI OH
45245-1306
US

V. Phone/Fax

Practice location:
  • Phone: 270-804-4474
  • Fax: 270-804-4478
Mailing address:
  • Phone: 304-949-1534
  • Fax: 304-949-1534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number33854
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number33854
License Number StateKY

VIII. Authorized Official

Name: ASHRAF S NASSEF
Title or Position: PRESIDENT
Credential: M.D.
Phone: 304-949-1534