Provider Demographics
NPI:1972691152
Name:NASR PSYCHIATRIC SERVICES, P.C.
Entity type:Organization
Organization Name:NASR PSYCHIATRIC SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUHAYL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:NASR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-872-1500
Mailing Address - Street 1:PO BOX 8852
Mailing Address - Street 2:
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46361-8852
Mailing Address - Country:US
Mailing Address - Phone:219-872-1500
Mailing Address - Fax:
Practice Address - Street 1:2814 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-6140
Practice Address - Country:US
Practice Address - Phone:219-872-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN500032242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN487590Medicare ID - Type Unspecified