MEDICARE: ASIF WAHID 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
1	207R00000X	Internal Medicine Physician	L9954	TX
2	207RC0000X	Cardiovascular Disease Physician	2006-01703	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	809115	OTHER	NC	BLUE MEDICARE
7	P00458936	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	144AR	OTHER	NC	BLUECROSS BLUESHIELD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	8R5337	OTHER	TX	BCBS OF TEXAS
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649260324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASIF WAHID MD

Provider Business Mailing Address
First Line	:	PO BOX 751803
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28275-1803
Country	:	US
Telephone Number	:	336-472-1191
Fax Number	:	336-472-1208

Provider Business Practice Location Address
First Line	:	211 OLD LEXINGTON RD
Second Line	:
City	:	THOMASVILLE
State	:	NC
Zip	:	27360-3428
Country	:	US
Telephone Number	:	336-472-1191
Fax Number	:	336-472-1208

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	10/28/2020

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Directions to “ ASIF WAHID MD” Practice Location

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