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NPI Code Detail

MEDICARE: SBN INCORPORATED

MEDICARE: SBN INCORPORATED
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
12084P0800XPsychiatry Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11962445668OTHERNCINDIVIDUAL NPI NUMBER

General Provider Information

NPI Number : 1598850844
Entity Type Code : Organization
Provider Name (Legal Business Name) : SBN INCORPORATED
Provider Business Mailing Address
First Line : 25 WINDING RIDGE RD
Second Line :
City : DURHAM
State : NC
Zip : 27713-5811
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2401 S SIDE BLVD
Second Line :
City : GREENSBORO
State : NC
Zip : 27406-3311
Country : US
Telephone Number : 919-491-3455
Fax Number : 919-859-5225
Authorized Official
Title or Position : PRESIDENT OF THE COMPANY
Name : DR. MOHAMMAD FAHIM-DANISH LATEEF
Credential : M.D
Telephone Number : 919-491-3455
Provider Enumeration Date : 10/03/2006
Last Update Date : 08/27/2013

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Directions to “SBN INCORPORATED ” Practice Location

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