Provider Demographics
NPI:1528687233
Name:KABIR, NUSRAT (MD)
Entity type:Individual
Prefix:
First Name:NUSRAT
Middle Name:
Last Name:KABIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:879 WILLIAM BLVD APT 1G
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-1511
Mailing Address - Country:US
Mailing Address - Phone:817-688-7973
Mailing Address - Fax:
Practice Address - Street 1:879 WILLIAM BLVD APT 1G
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-1511
Practice Address - Country:US
Practice Address - Phone:817-688-7973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-13
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program