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NPI Code Detail

MEDICARE: DR. SAMEEN MUJTABA

MEDICARE: DR. SAMEEN MUJTABA
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
1122300000XDentist14589NC

General Provider Information

NPI Number : 1619491883
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAMEEN MUJTABA
Provider Business Mailing Address
First Line : 6316 E INDEPENDENCE BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28212-6953
Country : US
Telephone Number : 704-280-7433
Fax Number :
Provider Business Practice Location Address
First Line : 6316 E INDEPENDENCE BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28212-6953
Country : US
Telephone Number : 980-575-1671
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2017
Last Update Date : 02/23/2026

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