Provider Demographics
NPI:1841297082
Name:ASHRAF, FARASAT IQBAL (MD)
Entity type:Individual
Prefix:DR
First Name:FARASAT
Middle Name:IQBAL
Last Name:ASHRAF
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 1:2615 WINTER STORM RD
Mailing Address - Street 2:
Mailing Address - City:ZEBULON
Mailing Address - State:NC
Mailing Address - Zip Code:27597-7363
Mailing Address - Country:US
Mailing Address - Phone:919-269-0759
Mailing Address - Fax:
Practice Address - Street 1:2615 WINTER STORM RD
Practice Address - Street 2:
Practice Address - City:ZEBULON
Practice Address - State:NC
Practice Address - Zip Code:27597-7363
Practice Address - Country:US
Practice Address - Phone:919-269-0759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-01
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000177174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89128HMMedicaid
NC2282813BMedicare PIN
NCH29914Medicare UPIN