Provider Demographics
NPI:1902093081
Name:AKHTAR, OMAR (MBBS)
Entity Type:Individual
Prefix:DR
First Name:OMAR
Middle Name:
Last Name:AKHTAR
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4760 E GALBRAITH RD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-6703
Mailing Address - Country:US
Mailing Address - Phone:513-686-2663
Mailing Address - Fax:513-686-3637
Practice Address - Street 1:4760 E GALBRAITH RD
Practice Address - Street 2:SUITE 212
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-6703
Practice Address - Country:US
Practice Address - Phone:513-686-2663
Practice Address - Fax:513-686-3637
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.099280207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH102460Medicare PIN