Healthcare Provider Details

I. General information

NPI: 1477658250
Provider Name (Legal Business Name): ATHAR HUSSAIN TEHSIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1638 OWEN DRIVE
FAYETTEVILLE NC
28304
US

IV. Provider business mailing address

PO BOX 40908
FAYETTEVILLE NC
28309-0908
US

V. Phone/Fax

Practice location:
  • Phone: 910-615-6030
  • Fax: 910-615-5080
Mailing address:
  • Phone: 910-615-6949
  • Fax: 910-615-9761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number2006-01505
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: