Healthcare Provider Details

I. General information

NPI: 1033226287
Provider Name (Legal Business Name): KARIM B. NAKHGEVANY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 WOODLAND AVE
PHILADELPHIA PA
19104-4551
US

IV. Provider business mailing address

302 FAIRVIEW RD
NARBERTH PA
19072-1335
US

V. Phone/Fax

Practice location:
  • Phone: 215-823-5880
  • Fax: 215-823-4309
Mailing address:
  • Phone: 610-668-9040
  • Fax: 610-668-8072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD035689-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: