Provider Demographics
NPI:1215109509
Name:NASIR, AYESHA S (MD)
Entity type:Individual
Prefix:
First Name:AYESHA
Middle Name:S
Last Name:NASIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:306 MINTON VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-9105
Mailing Address - Country:US
Mailing Address - Phone:919-865-8000
Mailing Address - Fax:919-865-8020
Practice Address - Street 1:12341 STRICKLAND RD
Practice Address - Street 2:SUITE 102
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-1273
Practice Address - Country:US
Practice Address - Phone:919-865-8000
Practice Address - Fax:919-865-8020
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC139328207QA0505X
NC2010-01420207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCAC3193226-5008OtherDEA