1699767665 NPI number — DR. AMIR M DARWISH M.D.

Table of content: DR. AMIR M DARWISH M.D. (NPI 1699767665)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699767665 NPI number — DR. AMIR M DARWISH M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DARWISH
Provider First Name:
AMIR
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699767665
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/16/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1005
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORRISVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27560-1005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-995-2651
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3916 BEN FRANKLIN BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27704-2383
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-956-9300
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/16/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  9500413 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2213686F . This is a "INDIVIDUAL MEDICARE PTAN" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 019EJ . This is a "NC BCBS GROUP NUMBER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 8927067 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 27067 . This is a "BCBS NC INDIV" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: N00414 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1634153 . This is a "UHC" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 110198077 . This is a "RAILROAD INDV NUMBER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 197707 . This is a "MEDCOST" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 7117082 . This is a "AETNA" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com