Healthcare Provider Details

I. General information

NPI: 1528404670
Provider Name (Legal Business Name): BILAL LATEEF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2013
Last Update Date: 02/28/2024
Certification Date: 02/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 HUFFMAN MILL RD
BURLINGTON NC
27215-8700
US

IV. Provider business mailing address

101 MANNING DR DEPARTMENT OF ANESTHESIOLOGY, CB# 7010
CHAPEL HILL NC
27514-4220
US

V. Phone/Fax

Practice location:
  • Phone: 336-538-7180
  • Fax:
Mailing address:
  • Phone: 919-966-5136
  • Fax: 919-966-4873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number2015-00747
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number191581
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: