Individual
FADY S NASRALLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
11176
ND
208600000X
Surgery Physician
A123254
CA
2086S0102X
Surgical Critical Care Physician
11176
ND
2086S0102X
Surgical Critical Care Physician
A123254
CA
2086S0127X
Trauma Surgery Physician
11176
ND
2086S0127X
Trauma Surgery Physician
Primary
A123254
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10408
—
ND
05
—
1871753905
—
CA
Enumeration date
06/12/2008
Last updated
05/02/2013
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