Healthcare Provider Details

I. General information

NPI: 1134135882
Provider Name (Legal Business Name): ASHRAF S NASSEF MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 06/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4404 GLEN ESTE WITHAMSVILLE RD
CINCINNATI OH
45245-1306
US

IV. Provider business mailing address

4404 GLEN ESTE WITHAMSVILLE RD
CINCINNATI OH
45245-1306
US

V. Phone/Fax

Practice location:
  • Phone: 513-943-1000
  • Fax:
Mailing address:
  • Phone: 513-943-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number35-074125
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number35-074125
License Number StateOH

VIII. Authorized Official

Name: ASHRAF S NASSEF
Title or Position: PRESIDENT
Credential: MD
Phone: 513-943-1000