Khaled Moustafa
Individual provider Active NPI Pharmacist · Elkin, NC
NPI 1588079636 · NPPES record last updated Jun 27, 2014
Key facts
- NPI
- 1588079636
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 20957 (NC)
- Practice address
- 548 CC Camp Rd
Elkin, NC 28621-8704 - Phone
- (336) 526-2640
- Fax
- (336) 526-2669
- NPI assigned
- Jun 27, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20957 | NC | MD | Psychiatry Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 20957 | NC | Yes |
Addresses
Primary practice location
548 CC Camp Rd
Elkin, NC 28621-8704
Mailing address
548 CC Camp Rd
Elkin, NC 28621-8704
Phone (336) 526-2640
Other providers in Elkin, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.