Basic Information
Provider Information
NPI: 1699974402
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ATTIAH
FirstName: NADIR
MiddleName: M
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2000 PERIMETER PARK DR STE 200
Address2:  
City: MORRISVILLE
State: NC
PostalCode: 275608442
CountryCode: US
TelephoneNumber: 9842154110
FaxNumber:  
Practice Location
Address1: 3333 SILAS CREEK PKWY
Address2:  
City: WINSTON SALEM
State: NC
PostalCode: 271033013
CountryCode: US
TelephoneNumber: 3367183550
FaxNumber: 3362776981
Other Information
ProviderEnumerationDate: 07/12/2007
LastUpdateDate: 06/10/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/10/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X2008-00072NCY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

ID Information
IDTypeStateIssuerDescription
590899205NC MEDICAID


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