Provider Demographics
NPI:1639155153
Name:AKBARI, GHULAM A (MD)
Entity Type:Individual
Prefix:DR
First Name:GHULAM
Middle Name:A
Last Name:AKBARI
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Gender:M
Credentials:MD
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Mailing Address - Street 1:315 S MANNING BLVD
Mailing Address - Street 2:HOSPITALIST PROGRAM - 6 CUSACK
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-1707
Mailing Address - Country:US
Mailing Address - Phone:518-525-8600
Mailing Address - Fax:518-525-6891
Practice Address - Street 1:4 ATRIUM DR
Practice Address - Street 2:SUITE 100; ATTN: TAMMY M. BUTTON
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-1441
Practice Address - Country:US
Practice Address - Phone:518-435-2740
Practice Address - Fax:518-458-2610
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2011-09-09
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Provider Licenses
StateLicense IDTaxonomies
NY234939207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11446467Medicaid
NY11446467Medicaid
NYI26791Medicare UPIN