Provider Demographics
NPI:1407020449
Name:NASIR, AMRA (MD)
Entity type:Individual
Prefix:
First Name:AMRA
Middle Name:
Last Name:NASIR
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12201 JUNIPER BLOSSOM PL
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-6345
Mailing Address - Country:US
Mailing Address - Phone:509-901-7575
Mailing Address - Fax:
Practice Address - Street 1:750 ROCKVILLE PIKE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1133
Practice Address - Country:US
Practice Address - Phone:301-424-0658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD77435207Q00000X
WAMD60173861207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine