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NPI Code Detail

MEDICARE: NASRAT G GHATTAS MD

MEDICARE: NASRAT G GHATTAS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation PhysicianMD417206PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538102645
Entity Type Code : Individual
Provider Name (Legal Business Name) : NASRAT G GHATTAS MD
Provider Business Mailing Address
First Line : 414 PAOLI PIKE
Second Line :
City : MALVERN
State : PA
Zip : 19355-3311
Country : US
Telephone Number : 610-640-7869
Fax Number : 610-251-5404
Provider Business Practice Location Address
First Line : 414 PAOLI PIKE
Second Line :
City : MALVERN
State : PA
Zip : 19355-3311
Country : US
Telephone Number : 610-640-7869
Fax Number : 610-251-5404
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2006
Last Update Date : 04/22/2008

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