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Organization
WAKE FOREST INTERNAL MEDICINE AND PRIMARY CARE
Active
Organization
WAKE FOREST INTERNAL MEDICINE AND PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMAD ABUL KALAM KHAN MD (PRESIDENT)
(919) 556-7499
Entity
Organization
Contact information
Practice address
1751 S MAIN ST, WAKE FOREST, NC 27587-9287
(919) 556-7499
(919) 562-0943
Mailing address
1751 S MAIN ST, WAKE FOREST, NC 27587-9287
(919) 556-7499
(919) 562-0943
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9500635
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890267T
—
NC
Enumeration date
01/30/2006
Last updated
03/14/2012
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