Healthcare Provider Details

I. General information

NPI: 1427229202
Provider Name (Legal Business Name): NASIM GHAFFAR, M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2008
Last Update Date: 03/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 NASHUA RD
DRACUT MA
01826-1929
US

IV. Provider business mailing address

505 NASHUA RD
DRACUT MA
01826-1929
US

V. Phone/Fax

Practice location:
  • Phone: 978-957-4474
  • Fax: 978-957-4475
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number46370
License Number StateMA

VIII. Authorized Official

Name: DR. NASIM GHAFFAR
Title or Position: OWNER
Credential: M.D.
Phone: 978-957-4474