Provider Demographics
NPI:1962631499
Name:SYED, FAISAL FIAZUDDIN (MD)
Entity Type:Individual
Prefix:
First Name:FAISAL
Middle Name:FIAZUDDIN
Last Name:SYED
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 1:160 DENTAL CIRCLE BURNETT WOMACK BUILDING CB #7075
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1301 CENTRAL DR
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4159
Practice Address - Country:US
Practice Address - Phone:919-718-9512
Practice Address - Fax:919-718-9516
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-06
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 129348207RC0001X
390200000X
MI4301106008207R00000X, 207RC0000X, 207RC0001X
NC2017-02221207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN060003705Medicare PIN