Provider Demographics
NPI:1093878159
Name:NAZIR, TARIQ (MD)
Entity Type:Individual
Prefix:DR
First Name:TARIQ
Middle Name:
Last Name:NAZIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1638 OWEN DR
Mailing Address - Street 2:ATTN: MANAGED CARE PLANNING
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3424
Mailing Address - Country:US
Mailing Address - Phone:910-615-6949
Mailing Address - Fax:910-615-9761
Practice Address - Street 1:6387 RAMSEY ST
Practice Address - Street 2:SUITE 140
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-9441
Practice Address - Country:US
Practice Address - Phone:910-615-3829
Practice Address - Fax:910-615-6216
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200401286207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC138PPOtherBCBSNC
NCD9487OtherMEDCOST
NC89138PPMedicaid
NCG79627Medicare UPIN
NCD9487OtherMEDCOST