Organization
SURGICAL MEDICAL CLINIC
Active
Other names
Dr Naseem Nasrallah
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NASEEM H NASRALLAH M.D (OWNER)
(910) 259-2161
Entity
Organization
Contact information
Practice address
407 EAST FREMONT STREET, BURGAW, NC 28425-0729
(910) 259-2161
(910) 259-7870
Mailing address
PO BOX 729, BURGAW, NC 28425-0729
(910) 259-2161
(910) 259-7870
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
19763
NC
363LP2300X
Primary Care Nurse Practitioner
5005024
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235445982
NC MEDICARE AND MEDICAID # PENDING FOR NPI # 1235445982
NC
05
—
7961886
—
NC
Enumeration date
01/03/2014
Last updated
01/03/2014
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