Provider Demographics
NPI:1205833787
Name:AKHTAR, M NAYEEM (MD)
Entity Type:Individual
Prefix:DR
First Name:M NAYEEM
Middle Name:
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 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:
Practice Address - Street 1:4200 HOSPITAL RD.
Practice Address - Street 2:
Practice Address - City:COAL TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:17866
Practice Address - Country:US
Practice Address - Phone:570-644-4325
Practice Address - Fax:570-644-4239
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD047557L207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02882100OtherCAPITAL BC GROUP ID
PA2830222OtherAETNA HEALTH PLANS ID
PA7991768OtherGATEWAY HEALTH PLAN ID
PA0019133700004Medicaid
PA0014276000003Medicaid
PA01018301OtherCAPITAL BC INDIVIDUAL ID
PR100016274OtherRAILROAD MEDICARE ID
PA742235OtherHIGHMARK BS INDIVIDUAL ID
PA1386458OtherHIGHMARK BS GROUP ID
PA8722OtherGEISINGER HEALTH PLAN ID
PA1386458OtherKEYSTONE HEALTH PLAN ID
PA0019133700004Medicaid
PA0014276000003Medicaid
PA0014276000003Medicaid