Provider Demographics
NPI:1043416118
Name:BARHAMS, AKIRA LANESE (MD)
Entity type:Individual
Prefix:
First Name:AKIRA
Middle Name:LANESE
Last Name:BARHAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 KIMEL FOREST DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6074
Mailing Address - Country:US
Mailing Address - Phone:336-716-1331
Mailing Address - Fax:
Practice Address - Street 1:905 PHILLIPS AVE
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7075
Practice Address - Country:US
Practice Address - Phone:336-802-2040
Practice Address - Fax:336-802-2041
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2024-02613207Q00000X
IN01068872A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201001110Medicaid
INP01270935OtherRR MEDICARE
IN201001110Medicaid
INP01270935OtherRR MEDICARE