Provider Demographics
NPI:1033226287
Name:NAKHGEVANY, KARIM B (MD)
Entity Type:Individual
Prefix:DR
First Name:KARIM
Middle Name:B
Last Name:NAKHGEVANY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:302 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-1335
Mailing Address - Country:US
Mailing Address - Phone:610-668-9040
Mailing Address - Fax:610-668-8072
Practice Address - Street 1:3900 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4551
Practice Address - Country:US
Practice Address - Phone:215-823-5880
Practice Address - Fax:215-823-4309
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD035689-L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0589864Medicaid
PA104554H8JMedicare ID - Type UnspecifiedMEDICARE NUMBER
PA0589864Medicaid