Provider Demographics
NPI:1083845234
Name:IQBAL, HAFIZ IMRAN (MD)
Entity Type:Individual
Prefix:DR
First Name:HAFIZ
Middle Name:IMRAN
Last Name:IQBAL
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 1:114 GOLDCREST DR
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-3666
Mailing Address - Country:US
Mailing Address - Phone:304-285-7101
Mailing Address - Fax:
Practice Address - Street 1:242 GEORGE ST
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-2641
Practice Address - Country:US
Practice Address - Phone:304-255-7878
Practice Address - Fax:304-256-0060
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV25012207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810029208Medicaid
WVP01538619OtherRAILROAD MEDICARE
WV003168219OtherHIGHMARK BLUECROSS BLUESHIELD
WV3810029208Medicaid