MEDICARE: FADI F NASR 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
1	207T00000X	Neurological Surgery Physician	22413	OK

General Provider Information

NPI Number	:	1609918416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FADI F NASR MD

Provider Business Mailing Address
First Line	:	4120 W MEMORIAL RD
Second Line	:	SUITE 300
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-9320
Country	:	US
Telephone Number	:	405-748-3300
Fax Number	:	405-749-1671

Provider Business Practice Location Address
First Line	:	4120 W MEMORIAL RD
Second Line	:	SUITE 300
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-9320
Country	:	US
Telephone Number	:	405-748-3300
Fax Number	:	405-749-1671

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	10/11/2011

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