Provider Demographics
NPI:1083631832
Name:MORAYATI, SHAMIL J (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAMIL
Middle Name:J
Last Name:MORAYATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2921 CROUSE LN
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-8833
Mailing Address - Country:US
Mailing Address - Phone:336-585-1212
Mailing Address - Fax:336-585-1112
Practice Address - Street 1:2921 CROUSE LN
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8833
Practice Address - Country:US
Practice Address - Phone:336-585-1212
Practice Address - Fax:336-585-1112
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33871207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2133OtherCIGNA
NC60589OtherBCBS
NC102661OtherUHC
NC11195OtherPARTNERS
NC1193071OtherFIRST HEALTH
NC55924OtherMEDCOST
NC890114EMedicaid
NC16229OtherWELLPATH
NC5888056OtherAETNA
NC890627OtherMAMSI
NC890114EMedicaid
NC5888056OtherAETNA