Provider Demographics
NPI:1306515820
Name:KADAH, AFNAN M (PA-C)
Entity type:Individual
Prefix:
First Name:AFNAN
Middle Name:M
Last Name:KADAH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AFNAN
Other - Middle Name:M
Other - Last Name:BEAUTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:611 CHURCH ST N
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-4322
Mailing Address - Country:US
Mailing Address - Phone:980-866-0466
Mailing Address - Fax:704-963-9038
Practice Address - Street 1:611 CHURCH ST N
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-4322
Practice Address - Country:US
Practice Address - Phone:704-963-9270
Practice Address - Fax:704-963-9038
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-11714363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0010-11714OtherNORTH CAROLINA MEDICAL BOARD