Provider Demographics
NPI:1114042223
Name:SANDHILLS INTERNAL MEDICINE CLINIC, PA
Entity Type:Organization
Organization Name:SANDHILLS INTERNAL MEDICINE CLINIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:M
Authorized Official - Last Name:DARWISH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-895-6650
Mailing Address - Street 1:PO BOX 1446
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28380-1446
Mailing Address - Country:US
Mailing Address - Phone:910-895-6650
Mailing Address - Fax:910-895-6682
Practice Address - Street 1:125 BILTMORE DR
Practice Address - Street 2:SUITE #2
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-4928
Practice Address - Country:US
Practice Address - Phone:910-895-6650
Practice Address - Fax:910-895-6682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC95-00413207R00000X
NC5005332363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5906208Medicaid
SCNPA860Medicaid
NC019EJOtherBC BS OF NC GROUP
NC232042OtherMEDICARE GROUP SIM
NCCG4083OtherRAILROAD MCR GROUP