Healthcare Provider Details

I. General information

NPI: 1205831229
Provider Name (Legal Business Name): HOMAYOON MOHAMMED AKBARI MD, PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 N MAIN ST
EMPORIA VA
23847
US

IV. Provider business mailing address

436 CLAIRMONT CT STE 105
COLONIAL HEIGHTS VA
23834-1765
US

V. Phone/Fax

Practice location:
  • Phone: 434-336-1222
  • Fax: 434-336-1788
Mailing address:
  • Phone: 804-504-4671
  • Fax: 804-765-6490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101058288
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number0101058288
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: