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NPI Code Detail

MEDICARE: MASHAAL BAKHTIAR MD

MEDICARE: MASHAAL BAKHTIAR MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramGA

General Provider Information

NPI Number : 1427998376
Entity Type Code : Individual
Provider Name (Legal Business Name) : MASHAAL BAKHTIAR MD
Provider Business Mailing Address
First Line : 503 DRAGBY LN
Second Line :
City : RALEIGH
State : NC
Zip : 27603-3676
Country : US
Telephone Number : 919-671-8580
Fax Number :
Provider Business Practice Location Address
First Line : 2501 N PATTERSON ST
Second Line :
City : VALDOSTA
State : GA
Zip : 31602-1735
Country : US
Telephone Number : 229-433-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2026
Last Update Date : 04/07/2026

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Directions to “ MASHAAL BAKHTIAR MD” Practice Location

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