Provider Demographics
NPI:1396358271
Name:DAHNOUN, ABID-ALHAMID (OD)
Entity Type:Individual
Prefix:
First Name:ABID-ALHAMID
Middle Name:
Last Name:DAHNOUN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 MELODY LN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-9101
Mailing Address - Country:US
Mailing Address - Phone:919-455-4551
Mailing Address - Fax:
Practice Address - Street 1:7800 FAYETTEVILLE RD.
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603
Practice Address - Country:US
Practice Address - Phone:984-810-5045
Practice Address - Fax:984-810-5046
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2615152WC0802X, 152WL0500X, 152WS0006X, 207W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1396358271Medicaid