Individual
MARK NASSIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6051 W EMERALD ST, BOISE, ID 83704
(208) 302-7600
(208) 302-7605
Mailing address
3340 E GOLDSTONE DR., MERIDIAN, ID 83642
(208) 302-7600
(208) 302-7605
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A70239
CA
2083X0100X
Occupational Medicine Physician
Primary
M14816
ID
Other
Enumeration date
09/19/2006
Last updated
05/29/2020
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