Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 19345 | NC |
N | 207Q00000X | Family Doctor | 38321 | NC |
Y | 208000000X | Pediatrician | 38321 | NC |
NPI | 1003889288 |
---|---|
Provider Name | Mr. Mian Bashir Daud |
First Address | Faison, NC 28341-0187 |
Second Address | Faison, NC 28341-0187 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2006 |
Last Update Date | 26/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12808 | BCBS (01) | NC |
8912808 | (05) | NC |
D82255 | (02) | NC |