Individual
DAVID NASRAZADANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1265 E PRIMROSE ST, SPRINGFIELD, MO 65804-4278
(417) 886-3937
(417) 886-1285
Mailing address
1010 N KANSAS ST, WICHITA, KS 67214-3124
(316) 293-1818
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
94-09368
KS
207W00000X
Ophthalmology Physician
Primary
2022035535
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200072849
—
MO
Enumeration date
07/05/2017
Last updated
09/28/2022
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