Healthcare Provider Details

I. General information

NPI: 1841297082
Provider Name (Legal Business Name): FARASAT IQBAL ASHRAF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 05/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2615 WINTER STORM RD
ZEBULON NC
27597-7363
US

IV. Provider business mailing address

2615 WINTER STORM RD
ZEBULON NC
27597-7363
US

V. Phone/Fax

Practice location:
  • Phone: 919-269-0759
  • Fax:
Mailing address:
  • Phone: 919-269-0759
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number200000177
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: