Provider Demographics
NPI:1134107022
Name:HAQUE, IMRAN PASHA (MD)
Entity Type:Individual
Prefix:
First Name:IMRAN
Middle Name:PASHA
Last Name:HAQUE
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 1:1380 EASTCHESTER DR STE 105
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-2659
Mailing Address - Country:US
Mailing Address - Phone:336-610-1300
Mailing Address - Fax:336-672-6001
Practice Address - Street 1:1380 EASTCHESTER DR STE 105
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-2659
Practice Address - Country:US
Practice Address - Phone:336-610-1300
Practice Address - Fax:336-672-6001
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200201092207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1655513OtherCIGNA
NC1318XOtherBCBS FEDERAL
NCD2749OtherMEDCOST
NC710950527OtherTRICARE
NC1318XOtherBCBSNC
NC891318XMedicaid
NC2123367OtherMAMSI
NC0408570OtherUNITED HEALTHCARE
NC2123367OtherMAMSI
NC891318XMedicaid