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General NPI Number Information
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NPI Number | 1598850844
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Entity Type | Organization
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Legal Business Name | SBN INCORPORATED
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 08/27/2013
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Provider Practice Location Address
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Address Line | 2401 S SIDE BLVD
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City | GREENSBORO
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State | NC
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Zip | 27406-3311
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Country | US
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Telephone | 919-491-3455
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Fax | 919-859-5225
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Provider Business Mailing Address
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Address Line | 25 WINDING RIDGE RD
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City | DURHAM
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State | NC
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Zip | 27713-5811
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT OF THE COMPANY
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Name | DR. MOHAMMAD FAHIM-DANISH LATEEF
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Credential | M.D
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Telephone | 919-491-3455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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