Provider Demographics
NPI:1164688032
Name:NORTHWOOD MEDICAL CENTER, P.A.
Entity Type:Organization
Organization Name:NORTHWOOD MEDICAL CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SASAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:ARAGHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-488-0157
Mailing Address - Street 1:116 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28301-7604
Mailing Address - Country:US
Mailing Address - Phone:910-488-0157
Mailing Address - Fax:910-488-0293
Practice Address - Street 1:116 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-7604
Practice Address - Country:US
Practice Address - Phone:910-488-0157
Practice Address - Fax:910-488-0293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC150707261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89137X3Medicaid