Individual
SHAHID M NASIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1052 PONTE VEDRA BLVD, PONTE VEDRA BEACH, FL 32082-4015
(904) 551-0703
(904) 551-0709
Mailing address
130 CORRIDOR RD UNIT 428, PONTE VEDRA BEACH, FL 32004-7718
(907) 551-0703
(904) 551-0709
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD17542
ME
2085R0202X
Diagnostic Radiology Physician
Primary
ME93304
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276663900
—
FL
Enumeration date
08/01/2006
Last updated
10/07/2021
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