Provider Demographics
NPI:1053389668
Name:AKHTAR, MATEEN (MD)
Entity type:Individual
Prefix:DR
First Name:MATEEN
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 1:910 BERKSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-4751
Mailing Address - Country:US
Mailing Address - Phone:919-989-7909
Mailing Address - Fax:919-989-3147
Practice Address - Street 1:910 BERKSHIRE RD
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4751
Practice Address - Country:US
Practice Address - Phone:919-989-7909
Practice Address - Fax:919-989-3147
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200802016207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC59-12087Medicaid
NC2073447Medicare PIN