Provider Demographics
NPI:1336115195
Name:CHATER, KAMAL (MD)
Entity Type:Individual
Prefix:
First Name:KAMAL
Middle Name:
Last Name:CHATER
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:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:920 CHURCH ST N
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2927
Practice Address - Country:US
Practice Address - Phone:704-403-1311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2008-01367207R00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2351728GOtherMEDICARE, OTHER INDIVIDUAL PTAN
PA101059720Medicaid
NC2022969AOtherMEDICARE, OTHER INDIVIDUAL PTAN
SCNC1269Medicaid
NC1336115195Medicaid
NC5910138Medicaid
NC232009OtherMEDICARE, ENTITY PTAN
NC2022969AOtherMEDICARE, OTHER INDIVIDUAL PTAN
NC5910138Medicaid
SCNC1269Medicaid
NC2022969BMedicare PIN