Wake Forest Internal Medicine and Primary Care

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

9500635 Issued in NC

Legal business name

WAKE FOREST INTERNAL MEDICINE AND PRIMARY CARE

Practice address

1751 S Main St
Wake Forest, NC 27587-9287

Phone

(919) 556-7499

Fax

(919) 562-0943

NPI assigned

Jan 30, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mohammad Abul Kalam Khan, MD

Title

President

Phone

(919) 556-7499

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331683200000",
    "number": "1568433282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1751 S MAIN ST",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275879287",
            "telephone_number": "919-556-7499",
            "fax_number": "919-562-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 S MAIN ST",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275879287",
            "telephone_number": "919-556-7499",
            "fax_number": "919-562-0943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE FOREST INTERNAL MEDICINE AND PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-30",
        "last_updated": "2012-03-14",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "ABUL KALAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-556-7499",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9500635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890267T",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wake Forest Adult Health Inc
• Wake Forest Chiropractic, PA
• Wake Forest Counseling Services, Inc.
• Wake Forest Drug Inc
• Wake Forest Family Eye Care, O.D., P.a.
• Wake Forest Optometry PA
• Wake Forest Peace of Mind, PLLC
• Wake Forest Pediatric Associates, PLLC
• Wake Forest Performance and Rehab
• Wake Forest Physical Therapy

• Internal Medicine Physician in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.