Provider Demographics
NPI:1871514968
Name:SOUEID, NASSIF ELIAS (MD, FACS)
Entity type:Individual
Prefix:
First Name:NASSIF
Middle Name:ELIAS
Last Name:SOUEID
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10845 PHILADELPHIA RD
Mailing Address - Street 2:
Mailing Address - City:WHITE MARSH
Mailing Address - State:MD
Mailing Address - Zip Code:21162-1717
Mailing Address - Country:US
Mailing Address - Phone:410-335-0008
Mailing Address - Fax:410-335-3113
Practice Address - Street 1:7505 OSLER DR
Practice Address - Street 2:SUITE 403
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7736
Practice Address - Country:US
Practice Address - Phone:410-321-0808
Practice Address - Fax:410-321-0887
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD609402086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD409076400OtherMEDICAL ASSISTANCE
GAP00860865OtherRAILROAD MEDICARE
DCM775 0001OtherCAREFIRST
MD140155ZB45OtherMEDICARE
MD64770106OtherCAREFIRST