Provider Demographics
NPI:1912914300
Name:AKHTAR, NADEEM (MD)
Entity type:Individual
Prefix:
First Name:NADEEM
Middle Name:
Last Name:AKHTAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 NC HIGHWAY 66 S STE 175
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-3855
Mailing Address - Country:US
Mailing Address - Phone:336-993-6120
Mailing Address - Fax:336-992-4811
Practice Address - Street 1:1635 NC HIGHWAY 66 S STE 175
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-3855
Practice Address - Country:US
Practice Address - Phone:336-993-6120
Practice Address - Fax:336-992-4811
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2002010302084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8913122Medicaid
NC8913122Medicaid