Healthcare Provider Details

I. General information

NPI: 1760325260
Provider Name (Legal Business Name): TAHA NADEEM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2026
Last Update Date: 04/10/2026
Certification Date: 04/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7003 CHAD COLLEY BOULEVARD BARLING
FORT SMITH AR
72916
US

IV. Provider business mailing address

510 COVENTRY RD APT 9A
DECATUR GA
30030-5041
US

V. Phone/Fax

Practice location:
  • Phone: 479-431-3500
  • Fax:
Mailing address:
  • Phone: 646-418-0466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: