Basic Information
| Provider Information | |||||||||
| NPI: | 1043577059 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZULFIQAR | ||||||||
| FirstName: | OMER | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3090 CARUSO CT STE 50 | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328068510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4074817179 | ||||||||
| FaxNumber: | 4074817190 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 BLYTHE BLVD | ||||||||
| Address2: | CMC ANNEX 1ST FLOOR | ||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043550720 | ||||||||
| FaxNumber: | 7043555948 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2012 | ||||||||
| LastUpdateDate: | 06/11/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 2014-02272 | NC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | ME136610 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | NC2422 | 05 | SC | MEDICAID | 1043577059 | 05 | NC | MEDICAID |