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NPI Code Detail

MEDICARE: EVAN Z NAKIB M.D.

MEDICARE:   EVAN Z NAKIB  M.D.
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
1207Q00000XFamily Medicine Physician201711LA
2207Q00000XFamily Medicine PhysicianP2741TX
3207Q00000XFamily Medicine PhysicianMD465794PA

General Provider Information

NPI Number : 1588830590
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVAN Z NAKIB M.D.
Provider Business Mailing Address
First Line : PO BOX 746722
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6722
Country : US
Telephone Number : 469-727-6675
Fax Number :
Provider Business Practice Location Address
First Line : 1336 CATASAUQUA RD
Second Line :
City : BETHLEHEM
State : PA
Zip : 18017-7402
Country : US
Telephone Number : 484-637-5006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2008
Last Update Date : 06/25/2025

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