Basic Information
Provider Information
NPI: 1366427171
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NSAH
FirstName: EMMANUEL
MiddleName: N
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 E CARROLL ST
Address2:  
City: SALISBURY
State: MD
PostalCode: 218015422
CountryCode: US
TelephoneNumber: 8007495191
FaxNumber: 4102195662
Practice Location
Address1: 400 EASTERN SHORE DR
Address2:  
City: SALISBURY
State: MD
PostalCode: 218045565
CountryCode: US
TelephoneNumber: 4107498906
FaxNumber: 4102195662
Other Information
ProviderEnumerationDate: 12/14/2005
LastUpdateDate: 07/14/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/14/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000XD42075MDN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207RC0001XD42075MDY Allopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology

ID Information
IDTypeStateIssuerDescription
75892120005MD MEDICAID


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