Provider Demographics
NPI:1376592451
Name:MASOUD, JAVED (MD)
Entity Type:Individual
Prefix:
First Name:JAVED
Middle Name:
Last Name:MASOUD
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 1:1236 HUFFMAN MILL RD
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-8700
Mailing Address - Country:US
Mailing Address - Phone:336-585-1813
Mailing Address - Fax:336-585-1816
Practice Address - Street 1:1236 HUFFMAN MILL RD
Practice Address - Street 2:SUITE 1400
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8700
Practice Address - Country:US
Practice Address - Phone:336-585-1813
Practice Address - Fax:336-585-1816
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23608207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC54624OtherBCBS
NC413262OtherWELL PATH
NC1376592451Medicaid
NCC81102Medicare UPIN
NC1376592451Medicaid
NC202151BMedicare PIN