Provider Demographics
NPI:1003889288
Name:DAUD, MIAN BASHIR (MD)
Entity Type:Individual
Prefix:MR
First Name:MIAN
Middle Name:BASHIR
Last Name:DAUD
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:P.O. BOX 187
Mailing Address - Street 2:
Mailing Address - City:FAISON
Mailing Address - State:NC
Mailing Address - Zip Code:28341-0187
Mailing Address - Country:US
Mailing Address - Phone:910-267-0421
Mailing Address - Fax:910-267-0441
Practice Address - Street 1:444 SW CENTER STREET
Practice Address - Street 2:
Practice Address - City:FAISON
Practice Address - State:NC
Practice Address - Zip Code:28341-0187
Practice Address - Country:US
Practice Address - Phone:910-267-0421
Practice Address - Fax:910-267-0441
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19345207Q00000X
NC38321208000000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC12808OtherBCBS
NC8912808Medicaid
NCD82255Medicare UPIN
NC2291145Medicare PIN