1114048238 NPI number — DR. NASEER AHMAD MOBASHAR M.D.

Table of content: DR. NASEER AHMAD MOBASHAR M.D. (NPI 1114048238)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114048238 NPI number — DR. NASEER AHMAD MOBASHAR M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOBASHAR
Provider First Name:
NASEER
Provider Middle Name:
AHMAD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114048238
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
186 LARKSPUR WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLOTTESVILLE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22902-8206
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-293-9754
Provider Business Mailing Address Fax Number:
434-293-9754

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BUCKINGHAM CORRECTIONAL CENTER
Provider Second Line Business Practice Location Address:
ROUTE 20
Provider Business Practice Location Address City Name:
DILLWYN
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23936
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-391-5980
Provider Business Practice Location Address Fax Number:
434-391-5984
Provider Enumeration Date:
04/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  0101026171 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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