Provider Demographics
NPI:1932186590
Name:KARAMOUZ, NASSER (MD)
Entity type:Individual
Prefix:
First Name:NASSER
Middle Name:
Last Name:KARAMOUZ
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 1:113 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02632-1416
Mailing Address - Country:US
Mailing Address - Phone:508-362-8080
Mailing Address - Fax:
Practice Address - Street 1:125 NASHUA ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-1101
Practice Address - Country:US
Practice Address - Phone:617-573-2614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-26
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA422772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB33537OtherBCBS MA
MA2072696Medicaid
MA705292OtherTUFTS HEALTH PLAN
MAB33537Medicare ID - Type Unspecified
MAB33537OtherBCBS MA