Provider Demographics
NPI:1063483113
Name:GARUBA, ABDUL KARIM (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDUL
Middle Name:KARIM
Last Name:GARUBA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3030 SENNA DR
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-6726
Mailing Address - Country:US
Mailing Address - Phone:704-844-8971
Mailing Address - Fax:704-844-8972
Practice Address - Street 1:9705 NORTHEAST PKWY STE 400
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-9704
Practice Address - Country:US
Practice Address - Phone:704-844-8971
Practice Address - Fax:704-844-8972
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200001378207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89132MMMedicaid
NCF88404Medicare UPIN
NC2011002Medicare ID - Type Unspecified