Healthcare Provider Details

I. General information

NPI: 1033154620
Provider Name (Legal Business Name): HAROON RASHID AFRIDI M.B.B.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1948 1ST AVE NE
CEDAR RAPIDS IA
52402-5321
US

IV. Provider business mailing address

1948 1ST AVE NE
CEDAR RAPIDS IA
52402-5321
US

V. Phone/Fax

Practice location:
  • Phone: 319-364-0121
  • Fax: 319-364-5684
Mailing address:
  • Phone: 319-364-0121
  • Fax: 319-364-5684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number36946
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0765169
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: