Healthcare Provider Details

I. General information

NPI: 1023209491
Provider Name (Legal Business Name): SCOTT DAVID NASH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2007
Last Update Date: 02/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10208 CERNY ST SUITE 308
RALEIGH NC
27617-7884
US

IV. Provider business mailing address

10208 CERNY ST SUITE 308
RALEIGH NC
27617-7884
US

V. Phone/Fax

Practice location:
  • Phone: 919-806-8500
  • Fax: 919-572-9659
Mailing address:
  • Phone: 919-806-8500
  • Fax: 919-572-9659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number200600648
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number200600648
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: