Provider Demographics
NPI:1083960124
Name:AKHTAR, FAHAD MALIK (MD)
Entity Type:Individual
Prefix:
First Name:FAHAD
Middle Name:MALIK
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 1:30 SADDLE CT
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-3503
Mailing Address - Country:US
Mailing Address - Phone:347-404-4271
Mailing Address - Fax:
Practice Address - Street 1:30 SADDLE CT
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831-3503
Practice Address - Country:US
Practice Address - Phone:347-404-4271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-26
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09812800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine