Provider Demographics
NPI:1407267750
Name:EFTEKHARY, NIMA (MD)
Entity Type:Individual
Prefix:DR
First Name:NIMA
Middle Name:
Last Name:EFTEKHARY
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 1:4601 PARK RD STE 250
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-2373
Mailing Address - Country:US
Mailing Address - Phone:704-323-2505
Mailing Address - Fax:
Practice Address - Street 1:1425 S. MAIN STREET
Practice Address - Street 2:ATTN: DEPT. OF ORTHOPEDIC SURGERY
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596
Practice Address - Country:US
Practice Address - Phone:925-295-4130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-08
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2019-00081207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0397730024OtherNSC#