Organization
MOUHAMED IYAD FAKHRI, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOUHAMED IYAD FAKHRI MD (OWNER)
(910) 590-0009
Entity
Organization
Contact information
Practice address
620 COLLEGE STREET, CLINTON, NC 28328
(910) 590-0009
(910) 590-2465
Mailing address
620 COLLEGE STREET, CLINTON, NC 28328
(910) 590-0009
(910) 590-2465
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200301225
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1350K
BLUE CROSS BLUE SHIELD
NC
01
—
187178
MEDCOST
—
05
—
891350K
—
NC
Enumeration date
08/25/2006
Last updated
08/18/2008
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