Provider Demographics
NPI:1962587386
Name:MAZHAR, IQBAL (MD)
Entity type:Individual
Prefix:DR
First Name:IQBAL
Middle Name:
Last Name:MAZHAR
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 1:420 PEACOCK ST
Mailing Address - Street 2:
Mailing Address - City:AHOSKIE
Mailing Address - State:NC
Mailing Address - Zip Code:27910-3930
Mailing Address - Country:US
Mailing Address - Phone:252-332-8016
Mailing Address - Fax:
Practice Address - Street 1:420 PEACOCK ST
Practice Address - Street 2:
Practice Address - City:AHOSKIE
Practice Address - State:NC
Practice Address - Zip Code:27910-3930
Practice Address - Country:US
Practice Address - Phone:252-332-8016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20822207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8955272Medicaid
NC208611Medicare ID - Type Unspecified
NC8955272Medicaid