Healthcare Provider Details

I. General information

NPI: 1710082425
Provider Name (Legal Business Name): AHMAD TAYYAB HAQ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 N MAIN ST STE 112
HIGH POINT NC
27262-3996
US

IV. Provider business mailing address

645 N MAIN ST
HIGH POINT NC
27260-5017
US

V. Phone/Fax

Practice location:
  • Phone: 336-883-0029
  • Fax: 336-916-4861
Mailing address:
  • Phone: 336-883-0029
  • Fax: 336-916-4861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number9600935
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number9600935
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: