Provider Demographics
NPI:1104177591
Name:ARIAS HEALTHCARE PA
Entity Type:Organization
Organization Name:ARIAS HEALTHCARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SUDIP
Authorized Official - Middle Name:K
Authorized Official - Last Name:ROY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-893-3806
Mailing Address - Street 1:108 DORSETT DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-2277
Mailing Address - Country:US
Mailing Address - Phone:704-893-3806
Mailing Address - Fax:704-639-3120
Practice Address - Street 1:108 DORSETT DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2277
Practice Address - Country:US
Practice Address - Phone:704-893-3806
Practice Address - Fax:704-639-3120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-25
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2002-0989208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCB992OtherMEDICARE PTAN
H74219Medicare UPIN
NC6727510001Medicare NSC