Nadra, Wissam Edward

Nadra, Wissam Edward is an individual health care provider with primary practice located at 275 N. Hwy 16. Suite: 103 Lakeshore Pediatric Center, Denver NC 28037. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Nadra, Wissam Edward can be contacted via phone (704) 489-8401.

Contact Information

Primary practice address
275 N. Hwy 16. Suite: 103 Lakeshore Pediatric Center Denver NC 28037
Phone: (704) 489-8401
Fax: (704) 489-8404
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2000-00103 North Carolina
Allopathic & Osteopathic Physicians / Pediatrics 208000000X A67393 California
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 27533 Arizona

Profile Details

NPI number 1154318350
LBN Legal business name Nadra, Wissam Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2005
Last updated Mar 7th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154318350 NPPES
North Carolina MEDICAID 89126ER
North Carolina MEDICAID 5950140

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