Provider Demographics
NPI:1427074616
Name:KADIR, HUMAYUN (MD)
Entity type:Individual
Prefix:
First Name:HUMAYUN
Middle Name:
Last Name:KADIR
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5221 PARAMOUNT PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5490
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6090 SIX FORKS RD STE A
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-8624
Practice Address - Country:US
Practice Address - Phone:919-870-0488
Practice Address - Fax:919-870-8898
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-01749207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5904841Medicaid
NC2005-01749OtherSTATE MEDICAL LICENSE
NC2053545Medicare PIN
NCI56758Medicare UPIN