Provider Demographics
NPI:1073622627
Name:SARMIENTO, PETE M (MD)
Entity Type:Individual
Prefix:
First Name:PETE
Middle Name:M
Last Name:SARMIENTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 N LINDSAY ST
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-4303
Mailing Address - Country:US
Mailing Address - Phone:336-812-3610
Mailing Address - Fax:336-883-0002
Practice Address - Street 1:3604 PETERS CT
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-9004
Practice Address - Country:US
Practice Address - Phone:336-812-3610
Practice Address - Fax:338-883-0002
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9700136207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCG59556Medicare UPIN
NC2446099BMedicare ID - Type UnspecifiedMEDICARE