Individual
ISSAM RAFIC NASR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
61 MEMORIAL MEDICAL PKWY, SUITE 2815, PALM COAST, FL 32164-5981
(386) 586-1850
(386) 586-1850
Mailing address
61 MEMORIAL MEDICAL PKWY, SUITE 2815, PALM COAST, FL 32164-5981
(386) 586-1810
(386) 586-1811
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
36550
IA
207RG0100X
Gastroenterology Physician
Primary
ME0109365
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0493098
—
IA
01
—
25320
WELLMARK BCBS
IA
Enumeration date
05/20/2006
Last updated
01/17/2020
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