Provider Demographics
NPI:1841232709
Name:WAHEED, WAQAR (MD)
Entity Type:Individual
Prefix:
First Name:WAQAR
Middle Name:
Last Name:WAHEED
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 1:89 S WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-3405
Mailing Address - Country:US
Mailing Address - Phone:802-862-5759
Mailing Address - Fax:802-658-0680
Practice Address - Street 1:89 S WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-3405
Practice Address - Country:US
Practice Address - Phone:802-862-5759
Practice Address - Fax:802-658-0680
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20020096052084N0400X
VT04200103352084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H71563Medicare UPIN