MEDICARE: DR. NASRULLAH GHAFOOR 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	208M00000X	Hospitalist Physician	ME68887	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1972585081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NASRULLAH GHAFOOR MD

Provider Business Mailing Address
First Line	:	4466 SWILCAN BRIDGE LN N
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32224-5617
Country	:	US
Telephone Number	:	904-281-0944
Fax Number	:	904-281-9806

Provider Business Practice Location Address
First Line	:	4466 SWILCAN BRIDGE LN N
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32224-5617
Country	:	US
Telephone Number	:	904-281-0944
Fax Number	:	904-281-9806

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

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	08/12/2014

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