Provider Demographics
NPI:1649260324
Name:WAHID, ASIF (MD)
Entity type:Individual
Prefix:
First Name:ASIF
Middle Name:
Last Name:WAHID
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:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:336-472-1191
Mailing Address - Fax:336-472-1208
Practice Address - Street 1:211 OLD LEXINGTON RD
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-3428
Practice Address - Country:US
Practice Address - Phone:336-472-1191
Practice Address - Fax:336-472-1208
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9954207R00000X
NC2006-01703207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5905546Medicaid
NC809115OtherBLUE MEDICARE
NC144AROtherBLUECROSS BLUESHIELD
TX170330801Medicaid
TX8R5337OtherBCBS OF TEXAS
LA1635383Medicaid
NCP00458936OtherRAILROAD MEDICARE
TX8C8753Medicare ID - Type Unspecified
LA1635383Medicaid
NC2061933AMedicare PIN
NCP00458936OtherRAILROAD MEDICARE