Provider Demographics
NPI:1639482284
Name:BOUKHAR, SARAG ABOUJAFAR (MD)
Entity Type:Individual
Prefix:
First Name:SARAG
Middle Name:ABOUJAFAR
Last Name:BOUKHAR
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 1:3 EXECUTIVE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-4007
Mailing Address - Country:US
Mailing Address - Phone:732-369-5994
Mailing Address - Fax:319-384-9613
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-384-9609
Practice Address - Fax:319-384-9613
Is Sole Proprietor?:No
Enumeration Date:2010-07-23
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-43247207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology