Provider Demographics
NPI:1477651925
Name:BUKHARI, MUSHTAQ A (MD)
Entity Type:Individual
Prefix:MR
First Name:MUSHTAQ
Middle Name:A
Last Name:BUKHARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:107B MICA AVE
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-8135
Mailing Address - Country:US
Mailing Address - Phone:828-437-7702
Mailing Address - Fax:828-437-7930
Practice Address - Street 1:107B MICA AVE
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-8135
Practice Address - Country:US
Practice Address - Phone:828-437-7702
Practice Address - Fax:828-437-7930
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC22893207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8919660Medicaid
NC8919660Medicaid
NC2020509FMedicare PIN