Provider Demographics
NPI:1376195230
Name:FAKHRI INTERNAL MEDICINE PA
Entity Type:Organization
Organization Name:FAKHRI INTERNAL MEDICINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOUHAMED
Authorized Official - Middle Name:IYAD
Authorized Official - Last Name:FAKHRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-258-3475
Mailing Address - Street 1:741B TILGHMAN DR
Mailing Address - Street 2:
Mailing Address - City:DUNN
Mailing Address - State:NC
Mailing Address - Zip Code:28334-5507
Mailing Address - Country:US
Mailing Address - Phone:252-258-3475
Mailing Address - Fax:
Practice Address - Street 1:741B TILGHMAN DR
Practice Address - Street 2:
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-5507
Practice Address - Country:US
Practice Address - Phone:252-258-3475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-11
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty