Provider Demographics
NPI:1851341366
Name:NASEER, KHALID (MD)
Entity type:Individual
Prefix:
First Name:KHALID
Middle Name:
Last Name:NASEER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SAINT ANTHONYS WAY STE 105
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-4580
Mailing Address - Country:US
Mailing Address - Phone:618-465-2761
Mailing Address - Fax:618-465-4750
Practice Address - Street 1:2 SAINT ANTHONYS WAY STE 105
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-4580
Practice Address - Country:US
Practice Address - Phone:618-465-2761
Practice Address - Fax:618-465-4750
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007001669207RG0100X
IL036121860207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP01135243OtherRAILROAD MEDICARE
MO207173600Medicaid
MO1851341366Medicaid
MO207173600Medicaid
MOMA4280004Medicare PIN
ILF400223462Medicare PIN
129430017Medicare PIN
MO126990001Medicare UPIN
MO969755654Medicare PIN