Healthcare Provider Details

I. General information

NPI: 1134631716
Provider Name (Legal Business Name): ADEL NASSER PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2017
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 MEDICINE CIRCLE
DURHAM NC
27710-0001
US

IV. Provider business mailing address

40 MEDICINE CIRCLE
DURHAM NC
27710-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-6437
  • Fax: 919-681-8147
Mailing address:
  • Phone: 919-684-6437
  • Fax: 919-681-8147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-16536
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA11670
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: